Otolaryngologists Demonstrate Low Agreement on Pediatric Airway Inflammation Assessment.

IF 2.2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Laryngoscope Pub Date : 2024-11-23 DOI:10.1002/lary.31926

Sweeya V Raj, Olivia L Prosak, Kaitlin July O'Brien, Jason S Park, Shilin Zhao, Christopher T Wootten

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Abstract

Objectives: Microlaryngoscopy and bronchoscopy (MLB) are essential tools for evaluating airway inflammation, but the reliability of endoscopic assessments for this purpose remains unclear. The aim of this study was to assess surgeons' interrater reliability during endoscopic assessment of airway inflammation. The endoscopic factors used to determine overall airway inflammation were also assessed.

Methods: We conducted a cross-sectional study involving 24 pediatric patients who underwent MLB and arytenoid biopsy. Surgeons rated airway inflammation based on endoscopic images, and interrater reliability was assessed using Fleiss' Kappa.

Results: Fleiss's Kappa demonstrated poor interrater reliability among all surgeons (0.111) and experienced surgeons (0.117). Surgeons varied in prioritizing visual features for assessing inflammation.

Conclusion: Current subjective assessments of airway inflammation during MLB exhibit poor interrater reliability, necessitating further research for improved diagnostic accuracy and informed treatment decisions in pediatric airway interventions.

Level of evidence: Level 3 Laryngoscope, 2024.

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耳鼻喉科医生对小儿气道炎症评估的一致性较低。

目的：显微喉镜和支气管镜（MLB）是评估气道炎症的重要工具，但内窥镜评估的可靠性仍不明确。本研究的目的是评估外科医生在内窥镜评估气道炎症时的相互间可靠性。同时还评估了用于确定整体气道炎症的内窥镜因素：我们进行了一项横断面研究，24 名儿科患者接受了 MLB 和杓状组织活检。外科医生根据内窥镜图像对气道炎症进行评分，并使用Fleiss'Kappa评估医生间的可靠性：结果：Fleiss's Kappa 显示，所有外科医生（0.111）和经验丰富的外科医生（0.117）之间的评分可靠性较差。外科医生在评估炎症时优先考虑的视觉特征方面存在差异：结论：目前对MLB过程中气道炎症的主观评估显示出较低的术者间可靠性，因此有必要开展进一步研究，以提高诊断准确性，并在小儿气道干预中做出明智的治疗决策：证据级别：3 级《喉镜》，2024 年。

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来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects