Interrater reliability of endoscopic parameters following sinus surgery

Area of Science:

• Otolaryngology
• Rhinology
• Surgical Outcomes Research

Background:

• Chronic rhinosinusitis (CRS) management often involves endoscopic sinus surgery (ESS).
• Objective assessment of surgical outcomes is crucial for patient care and research.
• Standardized scoring parameters are needed to evaluate the effectiveness of ESS.

Purpose of the Study:

• To assess the interrater reliability of specific postoperative endoscopic scoring parameters in patients with CRS following ESS.
• To validate the reproducibility of scoring for adhesion formation, middle turbinate position, inflammation, and crusting.

Main Methods:

• Prospective cohort study with retrospective review of 120 video-endoscopic evaluations from 20 subjects post-ESS.
• Evaluations were scored in real-time by performing clinicians and retrospectively by a blinded panel of four surgeons.
• Statistical analysis included Fleiss kappa and Shrout-Fleiss tests to determine interrater reliability for categoric and continuous data, respectively.

Main Results:

• Strong agreement was observed between panel raters for middle turbinate position (kappa=0.499) and adhesions (kappa=0.364).
• Good agreement was found for inflammation (reliability coefficient=0.554) and crusting (reliability coefficient=0.620).
• High agreement was also noted between real-time investigator scoring and panel scoring.

Conclusions:

• The evaluated endoscopic scoring parameters demonstrate acceptable interexaminer reproducibility.
• These parameters are suitable for consistent evaluation of outcomes in the postsurgical period after ESS for CRS.
• The findings support the use of these standardized tools in clinical practice and research.