Reliability of a pediatric sleep endoscopy scoring system

Area of Science:

• Pediatric Otolaryngology
• Sleep Medicine
• Surgical Assessment

Background:

• Obstructive Sleep Apnea (OSA) in children often requires surgical intervention.
• Drug Induced Sleep Endoscopy (DISE) aids surgical planning, but lacks a standardized scoring system for pediatric patients.
• Current systems, like VOTE, may not capture all relevant airway obstruction sites.

Purpose of the Study:

• To compare the reliability and utility of a novel DISE scoring system against the established VOTE system in pediatric OSA.
• To evaluate the performance of both systems in guiding surgical recommendations.

Main Methods:

• Thirty pediatric DISE videos were scored twice by five raters using both VOTE and the novel system.
• Intra-rater and inter-rater reliability were assessed using weighted kappa (WK) and Krippendorff's alpha (KA).
• Surgical intervention recommendations were analyzed for test-retest reliability.

Main Results:

• The novel system demonstrated comparable intra-rater reliability (WK: 0.62-0.87) to the VOTE system (WK: 0.50-1.00).
• Inter-rater reliability (KA) was also similar between the systems.
• While no significant difference was found in WK, the novel system showed a significant difference in percentage agreement (PA) (p=0.01).

Conclusions:

• The novel DISE scoring system exhibits reliable intra-rater and inter-rater performance in pediatric OSA.
• It offers a more comprehensive assessment by including additional sites of obstruction.
• The system shows promise for broader clinical adoption in managing pediatric OSA.