Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Scand J Med Sci Sports. 2023 Feb;33(2):189-196. doi: 10.1111/sms.14248. Epub 2022 Oct 29.
The Doha agreement classification is used to classify groin pain in athletes. We evaluated the inter-examiner reliability of this classification system. We prospectively recruited 48 male athletes (66 symptomatic sides) with groin pain between 10-2017 and 03-2020 at a sports medicine hospital in Qatar. Two examiners (23 and 10 years of clinical experience) performed history taking, and a standardized clinical examination blinded to each other's findings. Examiners classified groin pain using the Doha agreement terminology (adductor-, inguinal-, iliopsoas-, pubic-, hip-related groin pain, or other causes of groin pain). Multiple entities were ranked in order of perceived clinical importance. Each side was classified separately for bilateral groin pain. Inter-examiner reliability was calculated using Cohen's Kappa statistic (κ). Inter-examiner reliability was slight to moderate for adductor- (κ = 0.40), inguinal- (κ = 0.44), iliopsoas- (κ = 0.57), and pubic-related groin pain (κ = 0.12), substantial for hip-related groin pain (κ = 0.62), and slight for "other causes of groin pain" (κ = 0.13). Ranking entities in order of perceived clinical importance improved inter-examiner reliability for adductor-, inguinal-, and iliopsoas-related groin pain (κ = 0.52-0.65), but not for pubic (κ = 0.12), hip (κ = 0.51), and "other causes of groin pain" (κ = 0.03). For participants with unilateral groin pain classified with a single entity (n = 7), there was 100% agreement between the two examiners. Inter-examiner reliability of the Doha agreement meeting classification system varied from slight to substantial, depending on the clinical entity. Agreement between examiners was perfect when athletes were classified with a single clinical entity of groin pain, but lower when athletes were classified with multiple clinical entities.
多哈协议分类用于对运动员的腹股沟疼痛进行分类。我们评估了该分类系统的观察者间可靠性。我们前瞻性地招募了 2017 年 10 月至 2020 年 3 月在卡塔尔一家运动医学医院就诊的 48 名男性运动员（66 侧有症状）。两名观察者（23 年和 10 年的临床经验）进行了病史采集，并进行了标准化的临床检查，彼此的检查结果均为盲法。观察者使用多哈协议术语（内收肌、腹股沟、髂腰肌、耻骨、髋关节相关的腹股沟疼痛或其他腹股沟疼痛的原因）对腹股沟疼痛进行分类。多种实体按临床重要性依次排列。对于双侧腹股沟疼痛，每侧均单独进行分类。观察者间可靠性使用 Cohen's Kappa 统计量（κ）进行计算。内收肌（κ=0.40）、腹股沟（κ=0.44）、髂腰肌（κ=0.57）和耻骨相关的腹股沟疼痛（κ=0.12）的观察者间可靠性为轻度至中度，髋关节相关的腹股沟疼痛（κ=0.62）的观察者间可靠性为显著，“其他腹股沟疼痛的原因”（κ=0.13）的观察者间可靠性为轻度。按临床重要性对实体进行排序可提高内收肌、腹股沟和髂腰肌相关腹股沟疼痛的观察者间可靠性（κ=0.52-0.65），但对耻骨（κ=0.12）、髋关节（κ=0.51）和“其他腹股沟疼痛的原因”（κ=0.03）的观察者间可靠性无影响。对于被单一实体分类的单侧腹股沟疼痛的参与者（n=7），两名观察者之间的一致性为 100%。多哈协议会议分类系统的观察者间可靠性因临床实体而异，从轻度到显著不等。当运动员被分类为单一的腹股沟疼痛临床实体时，观察者之间的一致性为完美，但当运动员被分类为多个临床实体时，一致性则较低。
