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European Archives of Oto-Rhino-Laryngology

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01-05-2019 | Sleep Apnea | Miscellaneous

Inter-rater reliability between experienced and inexperienced otolaryngologists using Koo’s drug-induced sleep endoscopy classification system

Authors: Soo Kweon Koo, Sang Hoon Lee, Tae Kyung Koh, Young Jun Kim, Ji Seung Moon, Ho Byung Lee, Geun Hyung Park

Published in: European Archives of Oto-Rhino-Laryngology | Issue 5/2019

Abstract

Purpose

An ideal, drug-induced sleep endoscopy (DISE) classification system should cover all the upper airways, be simple and practical, and quantify the severity of any obstruction. Excellent validity and reliability are essential. We explored the inter-rater reliability of Koo’s DISE classification system in the hands of experienced and inexperienced otolaryngologists.

Methods

We retrospectively analyzed video images of 100 patients who underwent DISE examination in our hospital between 2015 and 2018. Three experienced and three inexperienced otolaryngologists reviewed and scored all images. We calculated the inter-rater reliabilities of the two groups of otolaryngologists.

Results

Independent of the extent of experience with DISE, detection of retropalatal obstructions (overall agreement: 0.87; kappa value: 0.60), and the degree of such obstructions (overall agreement: 0.67; kappa value: 0.52) were more consistent than were the detection of retrolingual obstructions (overall agreement: 0.61, kappa value: 0.37) and the degree of retrolingual obstructions (overall agreement: 0.20, kappa value: 0.35). Inexperienced observers were in good agreement for palatal obstructions and experienced observers were in good agreement for tongue-base obstructions. All of the otolaryngologists found it difficult to detect a lateral pharyngeal wall obstruction at the retrolingual level.

Conclusion

Koo’s DISE classification system focuses on surgical treatment, especially by otolaryngologists, and the degree of agreement between the experienced and inexperienced observers was relatively high. The participants’ level of experience had a strong impact on scoring. The less-experienced otolaryngologists tended to overlook tongue-base obstructions, focusing instead on relatively simple retropalatal obstructions. In the future, development of a DISE classification system that can be accepted globally will be necessary.

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Title: Inter-rater reliability between experienced and inexperienced otolaryngologists using Koo’s drug-induced sleep endoscopy classification system
Authors: Soo Kweon Koo
Sang Hoon Lee
Tae Kyung Koh
Young Jun Kim
Ji Seung Moon
Ho Byung Lee
Geun Hyung Park
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Keywords: Sleep Apnea
Endoscopy
Published in: European Archives of Oto-Rhino-Laryngology / Issue 5/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05386-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Inter-rater reliability between experienced and inexperienced otolaryngologists using Koo’s drug-induced sleep endoscopy classification system

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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