Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, CA 94115, USA.
Int Forum Allergy Rhinol. 2013 Jan;3(1):66-72. doi: 10.1002/alr.21074. Epub 2012 Aug 27.
There is an increasing need for a validated grading system to assess sinusitis severity as observed on endoscopic examination. Existing endoscopy scales have limitations in complexity, validation, and/or applicability. We present a novel and straightforward endoscopic scoring system measuring discharge, inflammation, and polyps/edema (DIP). The aim of this study is to determine correlation of the DIP score with existing sinus endoscopy scoring systems, and to determine interrater and test-retest reliability.
This retrospective cohort includes a total of 29 patients who underwent functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis. Sinus endoscopy videos were scored in a random and blinded fashion by 3 rhinologists (S.D.P., A.N.G., A.H.M.) using the Lund-Kennedy Endoscopic Score (LKES), the Perioperative Sinus Endoscopy (POSE) score, and the DIP score. Pearson correlation coefficients, interrater reliability and test-retest reliability were determined.
The results of this study show that the DIP score correlates well (p < 0.0001) with the existing LKES and POSE (Pearson correlation coefficients of 0.78 and 0.90, respectively). The interrater reliability intraclass correlation coefficient (ICC) is highest for the DIP score (0.87), followed by the POSE score (0.84) and the LKES (0.78). Test-retest reliability ICC is highest for the DIP score (0.78), followed by the POSE score (0.59) and the LKES (0.53).
The DIP score is a novel and straightforward endoscopic sinus scoring system that shows substantial test-retest and interrater reliability in the post-FESS population. It also demonstrates a high correlation with existing scoring parameters (LKES and POSE).
目前，人们越来越需要一种经过验证的分级系统来评估内镜检查时观察到的鼻窦炎严重程度。现有的内镜评分系统在复杂性、验证和/或适用性方面存在局限性。我们提出了一种新颖而直接的内镜评分系统，用于测量分泌物、炎症和息肉/水肿（DIP）。本研究的目的是确定 DIP 评分与现有的鼻窦内镜评分系统的相关性，并确定评分者间和重测信度。
本回顾性队列研究共纳入 29 例因慢性鼻-鼻窦炎接受功能性内镜鼻窦手术（FESS）的患者。由 3 名鼻科医生（S.D.P.、A.N.G.、A.H.M.）以随机和盲法方式对鼻窦内镜视频进行评分，使用 Lund-Kennedy 内镜评分（LKES）、围手术期鼻窦内镜评分（POSE）和 DIP 评分。确定了 Pearson 相关系数、评分者间信度和重测信度。
本研究结果显示，DIP 评分与现有的 LKES 和 POSE 评分高度相关（p < 0.0001），Pearson 相关系数分别为 0.78 和 0.90。DIP 评分的评分者间信度的组内相关系数（ICC）最高（0.87），其次是 POSE 评分（0.84）和 LKES（0.78）。DIP 评分的重测信度 ICC 最高（0.78），其次是 POSE 评分（0.59）和 LKES（0.53）。
DIP 评分是一种新颖而直接的内镜鼻窦评分系统，在 FESS 后人群中具有较高的重测信度和评分者间信度。它还与现有的评分参数（LKES 和 POSE）具有高度相关性。
