Related Experiment Video
Updated: Jul 13, 2025
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Development and validation of the international pediatric sleep endoscopy scale (IPSES)
Derek J Lam1, Norman R Friedman2, Kate C Chan3
1Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR, 97239, USA.
Insights
A new International Pediatric Sleep Endoscopy Scale (IPSES) was developed and validated for pediatric drug-induced sleep endoscopy (DISE). This reliable scale can be universally adopted for pediatric DISE assessments.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Medical Device Validation
Background:
- Pediatric drug-induced sleep endoscopy (DISE) is crucial for diagnosing upper airway obstruction.
- Existing DISE rating scales lack consensus and standardization.
- A validated, universal scoring scale is needed for pediatric DISE.
Purpose of the Study:
- To develop and validate a consensus International Pediatric Sleep Endoscopy Scale (IPSES).
- To establish a reliable and standardized scoring system for pediatric DISE.
Main Methods:
- Systematic review of existing DISE scales to develop a consensus scale.
- Refinement of the scale using 30 de-identified pediatric DISE video recordings.
- Validation of the IPSES using 25 de-identified pediatric DISE videos scored by independent raters.
- Inter-rater and intra-rater reliability assessed using weighted kappa statistics.
Main Results:
- The IPSES scale was developed incorporating common features and addressing controversial areas.
- Intra-rater reliability varied across airway levels, being most variable in the nasal airway (kappa 0.33-0.94) and best in the lateral oropharynx (kappa 0.68-0.95).
- Inter-rater reliability ranged from 0.43 (nasal airway) to 0.57 (soft palate).
Conclusions:
- The International Pediatric Sleep Endoscopy Scale (IPSES) demonstrates reliability.
- The IPSES effectively synthesizes existing scales and addresses areas of controversy.
- The IPSES is suitable for adoption as a universal scoring scale for pediatric DISE.
Objectives:
To develop and validate a consensus international pediatric sleep endoscopy scale (IPSES) for pediatric drug-induced sleep endoscopy (DISE).
Methods:
Existing published DISE ratings scales were reviewed in order to develop a consensus rating scale synthesizing the most common features and adding new elements to address areas of controversy. Samples of 30 de-identified DISE video recordings were reviewed to develop and refine the scale. After the consensus scale was defined, a separate sample of 25 de-identified DISE videos were scored with the new consensus scale by the development group and a panel of independent raters. A weighted kappa statistic was used to quantify the inter-rater and intra-rater reliability of the consensus scale at each anatomic level.
Results:
Among all raters, intra-rater reliability was most variable for the nasal airway (kappa range 0.33-0.94) and best for the lateral oropharynx (kappa range 0.68-0.95). Inter-rater reliability ranged from 0.43 for the nasal airway to 0.57 at the soft palate.
Conclusion:
The IPSES is a reliable consensus scale that reflects the most common features of existing scales and can be adopted as a universal scoring scale for pediatric DISE.
