Article
Interrater reliability of the ENTAS (Ear-, Nose- and Throat-Activity Score)
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Published: | July 6, 2010 |
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Introduction: The nasal mucosa is affected in more than 80% of the patients with WG. Therefore a reliable evaluation of the activity by an ENT specialist is mandatory. So far a suitable scoring system is missing. The proposed ENTAS is an advancement of the questionnaire introduced by Paulsen et al. 2001 in international agreement. The present study describes the interrater reliability of the evaluation of the global endonasal activity score.
Patients and methods: Four experienced (previous examination of more than 50 WG-patients) and four unexperienced (contact to <50 WG-patients) examiners assessed endonasal activity on the basis of 50 endoscopic endonasal photos of WG-patients. Activity was scored as no, mild, moderate or high. The interrater reliability was calculated by Cohen’s Kappa (κ).
Results: The reliability of the global score between experienced and unexperienced examiners is κ=0.1. If “none” and “mild” as well as “moderate” and “high” are grouped Cohen’s Kappa is κ=0.5. In the group of the experienced examiners the reliability of evaluation by the global score is κ=0.3, by the dichotic evaluation κ=0.6.
Conclusion: The interrater reliability of the global score between experienced and unexperienced examiners as well as in the group of the experienced examiners shows a poor concordance with κ<0.4. A good reliability is achieved by using the dichotic evaluation of the activity. The experienced examiners show a better agreement. Further studies will demonstrate if training of the examiners and a structured evaluation may improve the interrater reliability.