Validity and reliability of grade scoring in the diagnosis of exercise-induced laryngeal obstruction
The current gold-standard method for diagnosing exercise-induced laryngeal obstruction (EILO) is continuous laryngoscopy during exercise (CLE), with severity classified by a visual grade scoring system. We evaluated the precision of this approach, by evaluating test–retest reliability of CLE and bot...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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European Respiratory Society
2017-07-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/3/3/00070-2017.full |
| _version_ | 1819038175317721088 |
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| author | Emil Schwarz Walsted James H. Hull Jeppe Hvedstrup Robert Christiaan Maat Vibeke Backer |
| author_facet | Emil Schwarz Walsted James H. Hull Jeppe Hvedstrup Robert Christiaan Maat Vibeke Backer |
| author_sort | Emil Schwarz Walsted |
| collection | DOAJ |
| description | The current gold-standard method for diagnosing exercise-induced laryngeal obstruction (EILO) is continuous laryngoscopy during exercise (CLE), with severity classified by a visual grade scoring system. We evaluated the precision of this approach, by evaluating test–retest reliability of CLE and both inter- and intra-rater variability. In this prospective case–control study, subjects completed four consecutive treadmill CLE tests under identical conditions. Laryngoscopic video recordings were anonymised and graded by three expert raters. 2 months following initial scoring, videos were re-randomised and rating repeated to assess intra-rater agreement. 20 subjects (16 cases and four controls) completed four CLE tests. The time to exhaustion increased by 30 s (95% CI 0.02–57.8, p<0.05) in the second CLE compared with the first test, but remained identical in the subsequent tests. Only one-third of subjects retained their initial diagnosis in the subsequent three tests. Inter-rater agreement on grade scores (weighted Cohen's ϰ) was 0.16–0.45, while intra-rater agreement ranged from 0.30 to 0.67. The CLE test is key in the diagnostic assessment of patients with EILO. However, the widely adopted visual grade scoring system does not appear to be a robust means for reliably classifying severity of EILO. |
| first_indexed | 2024-12-21T08:33:08Z |
| format | Article |
| id | doaj.art-7bb48aca45c24c9081c470f4dbd1a593 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-12-21T08:33:08Z |
| publishDate | 2017-07-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-7bb48aca45c24c9081c470f4dbd1a5932022-12-21T19:10:09ZengEuropean Respiratory SocietyERJ Open Research2312-05412017-07-013310.1183/23120541.00070-201700070-2017Validity and reliability of grade scoring in the diagnosis of exercise-induced laryngeal obstructionEmil Schwarz Walsted0James H. Hull1Jeppe Hvedstrup2Robert Christiaan Maat3Vibeke Backer4 Respiratory Research Unit, Dept of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark Dept of Respiratory Medicine, Royal Brompton Hospital, London, UK Respiratory Research Unit, Dept of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark Dept of Otorhinolaryngology, Röpcke-Zweers Hospital, Hardenberg, The Netherlands Respiratory Research Unit, Dept of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark The current gold-standard method for diagnosing exercise-induced laryngeal obstruction (EILO) is continuous laryngoscopy during exercise (CLE), with severity classified by a visual grade scoring system. We evaluated the precision of this approach, by evaluating test–retest reliability of CLE and both inter- and intra-rater variability. In this prospective case–control study, subjects completed four consecutive treadmill CLE tests under identical conditions. Laryngoscopic video recordings were anonymised and graded by three expert raters. 2 months following initial scoring, videos were re-randomised and rating repeated to assess intra-rater agreement. 20 subjects (16 cases and four controls) completed four CLE tests. The time to exhaustion increased by 30 s (95% CI 0.02–57.8, p<0.05) in the second CLE compared with the first test, but remained identical in the subsequent tests. Only one-third of subjects retained their initial diagnosis in the subsequent three tests. Inter-rater agreement on grade scores (weighted Cohen's ϰ) was 0.16–0.45, while intra-rater agreement ranged from 0.30 to 0.67. The CLE test is key in the diagnostic assessment of patients with EILO. However, the widely adopted visual grade scoring system does not appear to be a robust means for reliably classifying severity of EILO.http://openres.ersjournals.com/content/3/3/00070-2017.full |
| spellingShingle | Emil Schwarz Walsted James H. Hull Jeppe Hvedstrup Robert Christiaan Maat Vibeke Backer Validity and reliability of grade scoring in the diagnosis of exercise-induced laryngeal obstruction ERJ Open Research |
| title | Validity and reliability of grade scoring in the diagnosis of exercise-induced laryngeal obstruction |
| title_full | Validity and reliability of grade scoring in the diagnosis of exercise-induced laryngeal obstruction |
| title_fullStr | Validity and reliability of grade scoring in the diagnosis of exercise-induced laryngeal obstruction |
| title_full_unstemmed | Validity and reliability of grade scoring in the diagnosis of exercise-induced laryngeal obstruction |
| title_short | Validity and reliability of grade scoring in the diagnosis of exercise-induced laryngeal obstruction |
| title_sort | validity and reliability of grade scoring in the diagnosis of exercise induced laryngeal obstruction |
| url | http://openres.ersjournals.com/content/3/3/00070-2017.full |
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