Inter-rater Reliability Study on Pattern Identification Using Nasal Endoscopy for Rhinitis

Objectives : To identify whether pattern identification using nasal endoscopy for rhinitis can be applied as a tool for evaluating rhinitis in routine care setting, we performed a inter-rater reliability study on this pattern identification. Methods : Two Korean medicine doctors assessed 290 left/right nasal endoscopy photograph cases of rhinitis patients with pattern identification using nasal endoscopy. This pattern identification consist of four assessment items, nasal membrane color(pale/hyperemia), nasal membrane humidity(dryness/dampness), rhinorrhea(watery/yellow), and turbinate membrane edema(atrophic/edematous). Cohen's kappa statistic and Percentage agreement were used to evaluate the inter-rater reliability. Results : Inter-rater percentage agreement and Kappa coefficient for left nasal endoscopy photograph cases was from 'slight' to 'moderate'(% agreement: 40.00-67.59%/Kappa: 0.06-0.407). Only the agreement of 'rhinorrhea (watery/yellow)' item was moderate(% agreement: 67.59%/Kappa: 0.407). Inter-rater percentage agreement and Kappa coefficient for right nasal endoscopy photograph cases was also from 'slight' to 'moderate'(% agreement: 42.41-68.97%/Kappa: 0.109-0.465). Only the agreement of 'rhinorrhea(watery/yellow)' item was moderate(% agreement: 68.97%/Kappa: 0.465). Conclusions : It is necessary to resolve problems such as cut-off value setting, bipolar evaluation values(pale/hyperemia, dryness/dampness, watery/yellow, atrophic/edematous) and weighting items. Further rigorous studies that overcome the limitations of the current research are warranted.

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