Validation of pharyngeal findings on sleep nasopharyngoscopy in children with snoring/sleep disordered breathing

Journal of Otolaryngology-Head & Neck Surgery

Hamdy El-Hakim³  David WJ Côté²  Caroline C Jeffery²  Vincent L Biron²  Maleka Ramji¹ 

[1] Department of Surgery, The Stollery Children’s Hospital, University of Alberta Hospitals, Edmonton, AB, Canada;Division of Otolaryngology, The Stollery Children’s Hospital, University of Alberta Hospitals, Edmonton, AB, Canada;Department of Pediatrics, The Stollery Children’s Hospital, University of Alberta Hospitals, Edmonton, AB, Canada

关键词: Adenotonsillectomy;    Diagnosis;    Agreement;    Propofol;    Endoscopy;    Children;    Sleep apnea;   

Others  :  861370
DOI  :  10.1186/1916-0216-43-13

 received in 2013-10-03, accepted in 2014-05-29,  发布年份 2014

【 摘 要 】

Objective

To validate the pharyngeal findings in sleep nasopharyngoscopy (SNP) of children with snoring - sleep disordered breathing (S-SDB).

Design

Prospective agreement diagnostic study on retrospective data.

Methods

We conducted an inter-and intra-rater agreement study on video documentations of SNP performed on children (non-syndromic, complex, or operated upon) who presented with S-SDB. The videos featured various pharyngeal findings (normal, collapse, mixed or obstruction). Three ‘non-expert’ raters at various stages in their otolaryngological careers rated the videos independently, and on two separate occasions following an instructional session. We calculated both weighted and non-weighted linear kappa.

Results

Each independent observer rated sixty-one videos (2 weeks apart). Intra-observer agreement was 0.64 ± 0.08 (95% CI 0.48-0.81), 0.74 ± 0.07 (95% CI 0.60-0.88), 0.59 ± 0.08 (95% CI 0.43-0.74), for raters 1, two and three. Weighted kappa was 0.6 ± 0.1 (95% CI 0.41-0.79), 0.8 ± 0.06 (95% CI 0.7-0.92), 0.7 ± 0.07 (95% CI 0.57-0.83), respectively. Inter-rater agreements between raters one and two, two and three, three and four were 0.83 ± 0.06 (95% CI 0.71-0.95), 0.52 ± 0.08 (95% CI 0.36-0.70), and 0.53 ± 0.08 (95% CI 0.37-0.69), respectively. Weighted kappa was 0.83 ± 0.073 (95% CI 0.69-0.98), 0.68 ± 0.06 (95% CI 0.56-0.79), and 0.64 ± 0.07 (95% CI 0.49-0.78), respectively.

Conclusions

This is the first validation of pharyngeal findings on SNP in children. It is based on a four types’ classification. Overall reproducibility amongst the three raters and their agreement was moderate to good. Further work should be phase four trials investigating the impact on outcome.

【 授权许可】

   
2014 Ramji et al.; licensee BioMed Central Ltd.

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