Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2013
Diagnosis of allergic rhinitis: inter-rater reliability and predictive value of nasal endoscopic examination: a prospective observational study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Eren E, Aktaş A, Arslanoğlu S, Kopar A, Ciğer E, Özkul Y, Önal K, Katılmiş H
Аннотация
OBJECTIVE: To determine the inter-rater reliability of nasal endoscopic findings and the feasibility of diagnosis of allergic rhinitis based solely on symptoms and nasal endoscopy.
DESIGN: Prospective observational study.
SETTING: University Teaching hospital.
PARTICIPANTS: One hundred and eight patients were referred from the allergy clinic included in the study.
MAIN OUTCOME MEASURES: Predictive value of symptoms and nasal endoscopic examination to diagnose allergic rhinitis and inter-rater reliability of the examination were evaluated.
RESULTS: Logistic regression analysis of patient symptoms and nasal examination findings revealed no significant predictive power for any of the symptoms or examination findings. The Fleiss κ coefficient of the three raters was calculated. Inter-rater variability among the three physicians demonstrated that mucosal oedema (κ = 0,48, P < 0.001), polypoid degeneration of the inferior turbinate tail (κ = 0.48, P = 0.01), nasal polyps (κ = 0.96, P < 0.001) and nasal septal deviation (κ = 0.65, P = 0.01) showed significant inter-rater agreement. A low κ coefficient (0.29) was found, and the inter-rater variability among physicians in interpreting the characteristics of nasal secretions was significant (P = 0.04). The inter-rater variability among the three physicians suggested that turbinate hypertrophy (κ = 0.31) and turbinate colour (κ = 0.38) showed no significant inter-rater agreement.
CONCLUSIONS: Patient symptoms and nasal endoscopy findings do not provide reliable diagnosis of allergic rhinitis. Turbinate colour and hypertrophy are believed to be related to allergic rhinitis; however, these were subject to marked inter-rater variability in this study.
DESIGN: Prospective observational study.
SETTING: University Teaching hospital.
PARTICIPANTS: One hundred and eight patients were referred from the allergy clinic included in the study.
MAIN OUTCOME MEASURES: Predictive value of symptoms and nasal endoscopic examination to diagnose allergic rhinitis and inter-rater reliability of the examination were evaluated.
RESULTS: Logistic regression analysis of patient symptoms and nasal examination findings revealed no significant predictive power for any of the symptoms or examination findings. The Fleiss κ coefficient of the three raters was calculated. Inter-rater variability among the three physicians demonstrated that mucosal oedema (κ = 0,48, P < 0.001), polypoid degeneration of the inferior turbinate tail (κ = 0.48, P = 0.01), nasal polyps (κ = 0.96, P < 0.001) and nasal septal deviation (κ = 0.65, P = 0.01) showed significant inter-rater agreement. A low κ coefficient (0.29) was found, and the inter-rater variability among physicians in interpreting the characteristics of nasal secretions was significant (P = 0.04). The inter-rater variability among the three physicians suggested that turbinate hypertrophy (κ = 0.31) and turbinate colour (κ = 0.38) showed no significant inter-rater agreement.
CONCLUSIONS: Patient symptoms and nasal endoscopy findings do not provide reliable diagnosis of allergic rhinitis. Turbinate colour and hypertrophy are believed to be related to allergic rhinitis; however, these were subject to marked inter-rater variability in this study.