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Poor interexaminer agreement on Friedman tongue position
Joar Sundman1, Johan Bring2, Danielle Friberg1
1a Department of Otorhinolaryngology , Karolinska University Hospital , Stockholm , Sweden.
Acta Oto-Laryngologica
|November 24, 2016
Summary
The Friedman tongue position shows poor agreement among doctors, suggesting it may be unreliable for selecting patients for uvulopalatopharyngoplasty surgery. This impacts obstructive sleep apnea treatment decisions.
Area of Science:
- Otorhinolaryngology
- Sleep Medicine
Background:
- The Friedman staging system aids in selecting patients with obstructive sleep apnea (OSA) for uvulopalatopharyngoplasty.
- Evaluating the reliability of its components is crucial for effective clinical application.
Purpose of the Study:
- To assess the inter-examiner agreement of the Friedman tongue position, a key component of the Friedman staging system.
- To determine the reliability of this method in clinical practice for OSA patient selection.
Main Methods:
- 15 Otorhinolaryngology physicians (11 residents, 4 specialists) evaluated tongue positions.
- Cohen's kappa analysis was used to quantify inter-examiner agreement across 210 evaluations.
- Kappa values range from 0 (disagreement) to 1 (complete agreement).
Main Results:
- The median kappa value was 0.36, with interquartile ranges of 0.23 and 0.42.
- This indicates only a slight level of agreement among the examiners.
- The results suggest variability in assessing the Friedman tongue position.
Conclusions:
- The Friedman tongue position demonstrated slight inter-examiner agreement.
- This suggests the method may be challenging to perform consistently.
- Its utility in reliably selecting patients for uvulopalatopharyngoplasty is questionable.
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