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KMID : 0931320170170010026
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대한상부위장관.헬리코박터학회지
2017 Volume.17 No. 1 p.26 ~ p.32
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Interrater Reliability among Endoscopists: Diagnosis of Laryngopharyngeal Reflux Based on the Reflux Finding Score Determined by Upper Endoscopy
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Lee Seok-Won
Bang Chang-Seok
Kim Yeon-Soo
Baik Gwang-Ho
Kim Dong-Kyu
Kim Young-Don
Lee Sang-Jin
Park Jong-Kyu
Seo Hyun-Il
Park Sung-Chul
Lee Sang-Hyuk
Lee Kyong-Joo
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Abstract
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Background/Aims: Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of gastroesophageal reflux disease. Endoscopic assessment of LPR is needed for convenient diagnosis and documentation of treatment efficacy. The aim of this study was to investigate the interrater reliability of LPR among endoscopists based on endoscopic laryngeal images.
Materials and Methods: Nineteen endoscopists participated in this study. Before the test, they completed an intensive education program by an otorhinolaryngologist on the reflux finding score (RFS), which is a validated laryngoscopic assessment of LPR. A total of 100 endoscopic laryngeal images were used for 3 tests of RFS. Cohen’s and Fleiss’ kappa coefficients were used to determine the degree of interrater agreement in the diagnosis of LPR.
Results: In the first test, the mean of Cohen’s kappa coefficients for LPR diagnosis between the otorhinolaryngologist and each of the 19 endoscopists was 0.3. In the second test, after additional education, the mean kappa value was 0.32. Fleiss’ kappa coefficients for diagnosis of LPR among the 19 endoscopists in the first and second tests were 0.30 and 0.26, respectively.
Conclusions: A short-term education program for endoscopists did not result in an improvement of accuracy in the diagnosis of LPR. Further studies using advanced educational programs for endoscopists are required.
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KEYWORD
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Gastroesophageal reflux, Endoscopy, Laryngopharyngeal reflux
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