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Reliability of the University of Miami chronic rhinosinusitis staging system
David A Lehman1, Roy R Casiano, Marek Polak
1Department of Otolaryngology, University of Miami School of Medicine, Miami, Florida, USA.
Background:
The aim of this study was to determine the interrater reliability and correlation between computed tomography (CT) and endoscopic components of the University of Miami (UM) Chronic Rhinosinusitis Staging System (UMCRSS), a comprehensive staging system for chronic rhinosinusitis (CRS).
Methods:
A prospective analysis of 55 patients undergoing endoscopic sinus surgeryfor CRS was performed. The population consisted of 28 men and 27 women, with a mean age of 45.9 years. All patients underwent staging, via the CT and endoscopic components of the UMCRSS in the operating room, by three examiners. The reliability of the system and all of its components was determined by kappa-coefficient analysis, comparing the data from all three examiners. Correlation between the CT and endoscopic arms was analyzed by Pearson's product moment coefficient.
Results:
Interrater reliability for the CT arm (kappa = 0.83) and endoscopic arm (kappa = 0.74 for the revision population, and kappa = 0.72 for the primary surgery population) were found to be significant. Endoscopic staging established significant correlation with CT staging (Pearson's r2 = 0.40; p < 0.0001 overall, 0.57, p < 0.0001 for revision, and 0.42, p < 0.0001 for primary cases).
Conclusion:
The UMCRSS is a comprehensive and reliable staging system with very strong and positive correlation between the CT and endoscopic components.