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Interrater variation of vascular classifications used in enhanced laryngeal contact endoscopy

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Combined use of contact endoscopy (CE) and Narrow Band Imaging (NBI, Olympus®) is suggested for the visualization of specific vascular changes indicative of glottic neoplasia. We investigated the interrater reliability and agreement in 3 recognized classification systems of vascular changes applied to images from CE + NBI in patients suspected for glottic neoplasia.

Methods

Six experienced head and neck surgeons familiar with NBI rated 120 images obtained by CE + NBI by 3 classification systems of vascular changes as suggested by Ni et al. (N-C), Puxeddu et al. (P-C), and the European Laryngological Society (ELS-C). Three raters were experienced in CE, and three raters had only limited experience with CE. Crude agreement and Fleiss’ kappa with 95% confidence interval were estimated for all 6 raters, and for the 2 levels of expertise for each original classification system and for dichotomized versions of the N-C and the P-C based on suggested neoplastic potential.

Results

The interrater crude agreement and the corresponding kappa values for the ELS-C were good and significantly higher than those for the N-C and P-C for all raters, irrespective of the level of experience with CE (p < 0.0001). There were no significant differences between the N-C and the P-C (p = 0.16). Kappa was considerably improved for both the N-C and the P-C to a level not different from the ELS-C (p = 0.21–0.71) when their 5 original categories were pooled into dichotomized classifications.

Conclusion

Difficulties in reliably classifying vascular changes in CE + NBI are evident. Two-tier classification systems are the most reliable.

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Funding

This study was supported by funds from the Toyota Foundation, which enabled the purchase of contact endoscopes for research use.

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Authors and Affiliations

  1. Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark

    Camilla Slot Mehlum, Helle Døssing, Ågot Møller Grøntved & Christian Godballe

  2. Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, Otto-von-Guericke University, Magdeburg, Germany

    Nikolaos Davaris, Anja Giers & Christoph Arens

  3. Department of Otorhinolaryngology‑Head and Neck Surgery, Aarhus University Hospital, Palle Juul‑Jensens Boulevard 165, 8200, Aarhus N, Denmark

    Thomas Kjaergaard

  4. OPEN ‑ Open Patient Data Explorative Network and Department of Clinical Research, Odense University Hospital and University of Southern Denmark, J. B. Winsløwsvej 9, 5000, Odense, Denmark

    Sören Möller

Authors
  1. Camilla Slot Mehlum
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  2. Helle Døssing
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  3. Nikolaos Davaris
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  4. Anja Giers
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  7. Sören Möller
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  8. Christian Godballe
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  9. Christoph Arens
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Corresponding author

Correspondence to Camilla Slot Mehlum.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed involving human participants were in accordance with the ethical standards of the University Hospital Magdeburg, Germany, and Odense University Hospital, Denmark, at which the study were conducted. Informed consent was obtained from all participants included in the study from University Hospital Magdeburg, Germany. According to Danish legislation, patient consent was not required for the participants included in the study from Odense University Hospital, Denmark, as no identifying information about participants was investigated in the study. The study was approved by the Danish Data Protection Agency, the local hospital management, and the legal department at Odense University Hospital (permit number 20/15307).

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Mehlum, C.S., Døssing, H., Davaris, N. et al. Interrater variation of vascular classifications used in enhanced laryngeal contact endoscopy. Eur Arch Otorhinolaryngol 277, 2485–2492 (2020). https://doi.org/10.1007/s00405-020-06000-z

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  • DOI: https://doi.org/10.1007/s00405-020-06000-z

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