Danilo Anunciatto Sguillar1,2, Tatiana de Aguiar Vidigal3, João Paulo Mangussi3, Lia Bittencourt4, Luiz Carlos Gregório3, Sergio Tufik4, Fernanda Louise Martinho Haddad5. 1. Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo-UNIFESP, São Paulo, Brazil. danilo_sguillar@hotmail.com. 2. , Rua Maestro Cardim 770, Bela Vista, São Paulo, SP, CEP 01323 001, Brazil. danilo_sguillar@hotmail.com. 3. Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo-UNIFESP, São Paulo, Brazil. 4. Discipline of Sleep Medicine and Biology, Department of Psychobiology, Federal University of São Paulo-UNIFESP, São Paulo, Brazil. 5. Department of Psychobiology, Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo-UNIFESP, São Paulo, Brazil.
Abstract
PURPOSE: The goal of this study was to investigate the agreement between examiners who were or were not trained in the physical examination of the upper airway (UA) and the craniofacial skeleton of individuals with obstructive sleep disorders (OSD). METHOD: A systematic assessment of the UA and craniofacial skeleton was performed on 55 individuals with OSD. The participants were consecutively assessed by three otorhinolaryngologists who specialized in sleep medicine for at least 1 year (trained examiners) and two doctors who were attending a residency program in otorhinolaryngology (untrained examiners). RESULTS: When analyzing all of the parameters assessed, the concordance was better in the trained group (k = 0.694, which is considered "good") compared to the untrained group (k = 0.475, "fair") (p < 0.001). The inter-examiner agreement was also better in the trained compared to the untrained group, as follows: craniofacial (k = 0.643 vs. 0.349), nasal (k = 0.657 vs. 0.614), and pharyngeal (k = 0.729 vs. 0.276) abnormalities (p < 0.05). CONCLUSION: The overall concordance of the physical examination of the UA and craniofacial skeleton was "good" among the trained specialists and "fair" among examiners without appropriate training, despite its subjectivity.
PURPOSE: The goal of this study was to investigate the agreement between examiners who were or were not trained in the physical examination of the upper airway (UA) and the craniofacial skeleton of individuals with obstructive sleep disorders (OSD). METHOD: A systematic assessment of the UA and craniofacial skeleton was performed on 55 individuals with OSD. The participants were consecutively assessed by three otorhinolaryngologists who specialized in sleep medicine for at least 1 year (trained examiners) and two doctors who were attending a residency program in otorhinolaryngology (untrained examiners). RESULTS: When analyzing all of the parameters assessed, the concordance was better in the trained group (k = 0.694, which is considered "good") compared to the untrained group (k = 0.475, "fair") (p < 0.001). The inter-examiner agreement was also better in the trained compared to the untrained group, as follows: craniofacial (k = 0.643 vs. 0.349), nasal (k = 0.657 vs. 0.614), and pharyngeal (k = 0.729 vs. 0.276) abnormalities (p < 0.05). CONCLUSION: The overall concordance of the physical examination of the UA and craniofacial skeleton was "good" among the trained specialists and "fair" among examiners without appropriate training, despite its subjectivity.
Authors: Y Finkelstein; D Wexler; E Horowitz; G Berger; A Nachmani; M Shapiro-Feinberg; D Ophir Journal: Laryngoscope Date: 2001-04 Impact factor: 3.325
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