Interobserver Consistency of Drug-Induced Sleep Endoscopy in Diagnosing Obstructive Sleep Apnea Using a VOTE...

Area of Science:

• Otolaryngology
• Sleep Medicine
• Medical Imaging

Background:

• Obstructive sleep apnea syndrome (OSAS) is a common condition requiring accurate upper airway assessment.
• Drug-induced sleep endoscopy (DISE) is a key diagnostic tool for evaluating airway collapse patterns in OSAS patients.

Purpose of the Study:

• To evaluate the interobserver consistency of DISE findings.
• To review the current literature on DISE interobserver reliability for OSAS.

Main Methods:

• 55 OSAS patients underwent DISE performed by a single surgeon.
• Three experienced surgeons independently reviewed DISE video recordings using the VOTE classification system.
• Analysis focused on the pattern, site, and degree of upper airway collapse.

Main Results:

• Interobserver consistency for velum obstruction ranged from poor to good across different configurations.
• Significant consistency was found for oropharynx lateral obstruction (kappa: 0.365).
• Fair to moderate consistency was observed for tongue base and epiglottis collapse (kappa >0.20).

Conclusions:

• Interobserver agreement in DISE interpretation for OSAS varies significantly.
• Standardization of DISE procedures, training, and interpretation is crucial.
• Larger studies are recommended to enhance the reliability of DISE findings.