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Pediatric Radiology

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01-01-2017 | Original Article

Conversion and reliability of two urological grading systems in infants: the Society for Fetal Urology and the urinary tract dilatation classifications system

Authors: Miran Han, Hyun Gi Kim, Jung-Dong Lee, Seon Young Park, Young Keun Sur

Published in: Pediatric Radiology | Issue 1/2017

Abstract

Background

The urinary tract dilation (UTD) classification system was proposed in 2014.

Objective

To evaluate the correspondence and reliability of two US grading systems for postnatal urinary tract dilatation in infants: the Society for Fetal Urology (SFU) and the UTD systems.

Materials and methods

We assessed 180 kidneys in infants younger than 1 year. Four radiologists assessed the kidneys twice using both the SFU system (grades 0 to 4) and the UTD system (grades normal, P1, P2, P3). The SFU system was re-categorized into SFU-A (grades 0, 1–2, 3, 4) and into SFU-B (grades 0–1, 2, 3, 4). The Cohen kappa statistic was used for estimating agreement of both UTD–SFU-A and UTD–SFU-B.

Results

The Cohen kappa was significantly higher between UTD and SFU-B as compared to the UTD and SFU-A (0.75 vs. 0.50, P < 0.001). Intra-observer agreement was similar for the two grading systems (SFU 0.64–0.88 vs. UTD 0.48–0.92, P = 0.050–0.885). SFU grades 2 and 3 showed fair to moderate inter-observer agreement and corresponding UTD grades P1 and P2 showed moderate to substantial agreement. The overall inter-observer agreement was significantly higher for the UTD system than for the SFU system during the first assessment (95% confidence interval [CI]: right kidney, −0.069 to −0.062; left kidney, −0.048 to −0.043).

Conclusion

Correspondence between the systems was poor using a recommended re-categorization (SFU-A). An alternative re-categorization (SFU-B) was found to be more appropriate for establishing correspondence between the systems. Both systems were reliable, with good intra- and inter-observer agreement for the assessment of infant kidneys, but the UTD system had better inter-observer agreement.

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Title: Conversion and reliability of two urological grading systems in infants: the Society for Fetal Urology and the urinary tract dilatation classifications system
Authors: Miran Han
Hyun Gi Kim
Jung-Dong Lee
Seon Young Park
Young Keun Sur
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Radiology / Issue 1/2017
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-016-3721-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Conversion and reliability of two urological grading systems in infants: the Society for Fetal Urology and the urinary tract dilatation classifications system

Abstract

Background

Objective

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

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