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Classification and stratification in pilonidal sinus disease: findings from the PITSTOP cohort
Matthew J Lee1, Ellen Lee2, Mike Bradburn2
1Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK.
Summary
The International Pilonidal Society (IPS) classification tool shows good reliability and validity for pilonidal disease, supporting its clinical use. This study assessed the IPS tool
Area of Science:
- Pilonidal disease research
- Medical classification systems
- Surgical outcomes assessment
Background:
- Pilonidal disease classification lacks consistency, hindering research.
- The International Pilonidal Society (IPS) proposed a four-part classification in 2017.
- Validating the IPS classification is crucial for its adoption.
Purpose of the Study:
- To assess the validity and reliability of the International Pilonidal Society (IPS) classification tool.
- To evaluate the IPS classification using data from the PITSTOP cohort study.
Main Methods:
- Face validity assessed by comparing IPS items to existing classification tools.
- Concurrent and predictive validity evaluated using patient-reported outcomes (health utility, CWIQ, pain).
- Interrater reliability tested on 90 images by six raters using kappa and Gwet's AC1 statistics.
Main Results:
- IPS classification items are present in other systems, supporting face validity.
- Differences in health utility and pain observed between groups, indicating concurrent/predictive validity.
- Interrater reliability showed moderate agreement (kappa 0.52, Gwet's AC1 0.63).
Conclusions:
- The IPS classification demonstrates acceptable reliability and validity.
- Findings support the implementation of the IPS classification in clinical practice and research.
