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Validation of a grading system for lateral nasal wall insufficiency
Gabriel J Tsao1, Natalia Fijalkowski, Sam P Most
1Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California.
Abstract:
This study was designed to validate a grading scheme for lateral nasal wall insufficiency with interrater and intrarater reliability measures. Representative endoscopic videos depicting varied degrees of lateral nasal wall insufficiency were collated into a 30-clip video (15 clips in duplicate). This was rated by five reviewers for a total of 150 observations. Interrater and intrarater reliability were determined using Fleiss kappa and intraclass correlation coefficient (ICC) statistics, respectively. Good agreement was established between reviewers (interrater reliability), with a Fleiss kappa of 0.7733 (p < 0.01). Analysis of intrarater variability with the ICC revealed a very strong agreement (ICC = 0.88; p < 0.01). The proposed grading system is shown to have good interrater and intrarater reliability. It provides a reliable instrument for assessing lateral wall insufficiency.
Insights
A new grading system for lateral nasal wall insufficiency demonstrates high reliability among clinicians. This validated tool offers a dependable method for assessing nasal wall issues.
Area of Science:
- Otolaryngology
- Rhinology
- Medical Imaging Analysis
Background:
- Lateral nasal wall insufficiency is a condition affecting nasal airflow and structure.
- Accurate assessment is crucial for diagnosis and treatment planning.
- Existing grading systems may lack robust validation.
Purpose of the Study:
- To validate a novel grading scheme for lateral nasal wall insufficiency.
- To establish interrater and intrarater reliability for the proposed grading system.
Main Methods:
- A 30-clip endoscopic video library of lateral nasal wall insufficiency was created.
- Five reviewers assessed the videos, yielding 150 total observations.
- Fleiss kappa and intraclass correlation coefficient (ICC) statistics were used to measure reliability.
Main Results:
- Good interrater agreement was observed, with a Fleiss kappa of 0.7733 (p < 0.01).
- Very strong intrarater agreement was found, indicated by an ICC of 0.88 (p < 0.01).
Conclusions:
- The developed grading system exhibits strong interrater and intrarater reliability.
- This system provides a dependable instrument for evaluating lateral nasal wall insufficiency.
