Interobserver agreement on DISE: Do we all see the same?

Abstract

Objectives: Evaluate interobserver agreement on DISE classification and consequent therapeutic decision-making.

Study design: Cross-sectional.

Material & methods: 20 DISEs performed in adults at one Hospital were recorded. Videos were reviewed by six observers (3 senior Otolaryngologists and 3 residents). The observers rated the exam findings and suggested the best treatment for each case. Kappa coefficient(K) was used to evaluate interobserver agreement.

Results and Conclusions: Airway obstruction was assessed by seniors and residents and, in this parameter, there was 100% agreement between groups at the level of soft palate(K=1), 90% at oropharynx(K=0,69), 85% at tongue base(K=0,68) and 85% at epiglottis(K=0,69). Concerning to the severity of the obstruction, interobserver agreement was moderate to high at every level except at tongue base(K=0,38). With regard to the treatment, we found a higher rate of indication for tongue base surgery from residents(7/20) comparing to specialists(1/20); k=0,34 (p=0,04).

Consequently, agreement between residents and seniors seems to be quite acceptable except on grading severity of obstruction at the level of tongue base (weak agreement) and therapeutic decision on the same anatomical area (weak agreement).