Rating visualization in shoulder arthroscopy: A comparison of the visual analog scale versus a novel shoulder arthroscopy grading scale

PURPOSE: To assess the interobserver reliability and intraobserver variability of the visual analog scale (VAS) for visualization in shoulder arthroscopy and compare it to a less variable, more objective novel grading scale, the shoulder arthroscopy grading scale (SAGS). METHODS: Twenty separate 30-s length video clips were created from a library of shoulder arthroscopies. Video clips were randomized and distributed to six sports medicine fellowship-trained surgeons at two time points with a 1-month interval. Each rated visualization according to an adapted VAS and a novel grading scale, the SAGS. RESULTS: The VAS and SAGS both showed an excellent degree of consistency with interobserver reliability among raters with intraclass correlation coefficients (ICCs) of 0.96 and 0.97, respectively. Five of six raters demonstrated strong intraobserver variability with the VAS and SAGS with ICC ranging from 0.87 to 0.97 and 0.61 to 0.93, respectively. CONCLUSION: Given the strong-to-excellent degree of consistency in using the VAS and the SAGS, either can be reliably used as a measurement of visualization in shoulder arthroscopy.