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The validity of nasal endoscopy in patients with chronic rhinosinusitis—An inter‐rater agreement study

2017; Wiley; Volume: 43; Issue: 1 Linguagem: Inglês

10.1111/coa.12916

1749-4486

K.L. Larsen, Bibi Lange, Peter Darling, Gita Jørgensen, Anette Drøhse Kjeldsen,

Allergic Rhinitis and Sensitization

Objectives Nasal endoscopy is a cornerstone in diagnosing sinonasal disease, but different raters might generate different results using the technique. Our study aims to evaluate the agreement between multiple raters to assess the validity of nasal endoscopy. Design/Participants Three independent and blinded raters evaluated 28 patients (56 nasal cavities) diagnosed with chronic rhinosinusitis according to the European Position Paper on Rhinosinusitis and Nasal Polyps. The ratings were compared using unweighted Fleiss’ kappa coefficients ( K f ) for each objective parameter. Setting The department of Otorhinolaryngology, Odense University Hospital, Denmark. Main outcome measures The ratings were quantified in a modified Lund‐Kennedy endoscopy score and focused on the objective parameters specified in the diagnostic criteria: polyps, oedema and discharge. Results The raters agreed on the findings concerning polyps and discharge but not regarding oedema with the inter‐rater agreement for the different parameters being: polyps K f =.66 ( SE .07, P <.001), oedema K f =.05 ( SE .07, P =.21), discharge K f =.35 ( SE .08, P <.001), oedema exclusively in middle meatus K f =−.07 ( SE .04, P =.8) and discharge exclusively in middle meatus K f =.16 ( SE .07, P =.01). Conclusion Using nasal endoscopy, the evaluation of polyps by multiple raters showed sufficient reliability indicating an acceptable objective evaluation. The evaluation of discharge achieved a fair level of agreement while the assessment of oedema could not achieve a sufficient reliability questioning the inclusion of oedema in the criteria for diagnosing sinonasal disease.