Intra- and inter-observer reproducibility of the Recurrent Varicose Veins after Surgery (REVAS) classification

To evaluate intra- and inter-observer reproducibility of the classification for recurrent varicose veins after surgery (REVAS).

Intra- and inter-observer reproducibility of each component of the REVAS classification were evaluated by a Kappa test.

A multi-centre study conducted in 8 countries enrolled 199 REVAS patients. Patients were examined twice by the same observer, and once by another physician. Investigations included physical examination and duplex scanning. A form based on the CEAP and the REVAS classification was filled in after each examination.

The analysis revealed that of the 8 items in the REVAS, intra-observer reproducibility was excellent for three items and good for five, and that inter-observer reproducibility was good for 6 items and moderate for two. Making a slight change in the proposed answers to one question, which is somewhat ambiguous, would increase inter-observer reproducibility. Analysis of the cause of intermediate reproducibility underlines the necessity of validating a duplex scanning protocol and a standardised duplex scanning report.

The good or excellent intra-observer reproducibility of the REVAS provides the main required criteria for use in clinical trials or cohort studies where patients are usually followed up by the same investigator to determine their spontaneous or treatment-related outcome.