Abstract：
BACKGROUND: Subglottic stenosis (SGS) is a condition leading to narrowing of the upper airway which can lead to dyspnea and life-threatening airway obstruction. Although other proposed grading systems exist, the Cotton Myer (CM) and percent stenosis systems are the most widespread in clinical practice. Despite this, the CM system has not yet been validated for visual assessment of SGS.
OBJECTIVE: To determine the interrater and intrarater reliability of the CM grading system among a cohort of physicians who manage patients with SGS.
METHODS: An online survey created with videos of tracheoscopies from 20 adult patients with subglotticstenosis (SGS) was sent individually to 9 expert physicians from various medical specialties, all of whom managed patients with SGS. Physicians were asked to view the 20 tracheoscopy videos and assess both the percent stenosis and Cotton Myer (CM) grade of each patient. After a period of 4 weeks, the physicians were sent the same survey of the 20 tracheoscopy videos. The interrater and intrarater reliability was calculated using the intraclass correlation coefficient (ICC), a measurement used to evaluate the reliability (the extent to which a measurement can be replicated) of two or more raters measuring the same subject.
RESULTS: Overall, CM and percent stenosis systems were found to have an ICC of 0.94 and 0.90 within the domain of interrater reliability, respectively, and ICC of 0.71 and 0.81 within the domain of intrarater reliability, respectively.
CONCLUSIONS: Our findings suggest that the CM and percent stenosis grading systems remain a valid clinical tool to measure and communicate the severity of airway obstruction in SGS.
OBJECTIVE: To determine the interrater and intrarater reliability of the CM grading system among a cohort of physicians who manage patients with SGS.
METHODS: An online survey created with videos of tracheoscopies from 20 adult patients with subglotticstenosis (SGS) was sent individually to 9 expert physicians from various medical specialties, all of whom managed patients with SGS. Physicians were asked to view the 20 tracheoscopy videos and assess both the percent stenosis and Cotton Myer (CM) grade of each patient. After a period of 4 weeks, the physicians were sent the same survey of the 20 tracheoscopy videos. The interrater and intrarater reliability was calculated using the intraclass correlation coefficient (ICC), a measurement used to evaluate the reliability (the extent to which a measurement can be replicated) of two or more raters measuring the same subject.
RESULTS: Overall, CM and percent stenosis systems were found to have an ICC of 0.94 and 0.90 within the domain of interrater reliability, respectively, and ICC of 0.71 and 0.81 within the domain of intrarater reliability, respectively.
CONCLUSIONS: Our findings suggest that the CM and percent stenosis grading systems remain a valid clinical tool to measure and communicate the severity of airway obstruction in SGS.
摘要：
背景：声门下狭窄（SGS）是一种导致上呼吸道狭窄的疾病，可导致呼吸困难和危及生命的气道阻塞。尽管存在其他拟议的分级系统，CottonMyer（CM）和狭窄百分比系统在临床实践中最普遍。尽管如此,CM系统尚未通过SGS的视觉评估验证。
目的：确定使用SGS管理患者的医师队列中CM分级系统的评分者和评分者内部的可靠性。
方法：通过20名声门下狭窄（SGS）成年患者的气管镜检查视频创建的在线调查，分别发送给了来自各个医学专业的9名专家医生，所有这些人都用SGS管理患者。要求医生查看20个气管镜检查视频，并评估每位患者的狭窄百分比和CottonMyer（CM）等级。4周后,向医生发送了20个气管镜检查视频的相同调查。使用组内相关系数(ICC)计算评分者和评分者内部可靠性，用于评估两个或多个评估者测量同一受试者的可靠性（测量可以复制的程度）的测量。
结果：总体而言，发现CM和狭窄百分比系统在评估者间可靠性范围内的ICC为0.94和0.90，分别,在内部可靠性范围内的ICC为0.71和0.81，分别。
结论：我们的研究结果表明，CM和狭窄百分比分级系统仍然是SGS中测量和传达气道阻塞严重程度的有效临床工具。
目的：确定使用SGS管理患者的医师队列中CM分级系统的评分者和评分者内部的可靠性。
方法：通过20名声门下狭窄（SGS）成年患者的气管镜检查视频创建的在线调查，分别发送给了来自各个医学专业的9名专家医生，所有这些人都用SGS管理患者。要求医生查看20个气管镜检查视频，并评估每位患者的狭窄百分比和CottonMyer（CM）等级。4周后,向医生发送了20个气管镜检查视频的相同调查。使用组内相关系数(ICC)计算评分者和评分者内部可靠性，用于评估两个或多个评估者测量同一受试者的可靠性（测量可以复制的程度）的测量。
结果：总体而言，发现CM和狭窄百分比系统在评估者间可靠性范围内的ICC为0.94和0.90，分别,在内部可靠性范围内的ICC为0.71和0.81，分别。
结论：我们的研究结果表明，CM和狭窄百分比分级系统仍然是SGS中测量和传达气道阻塞严重程度的有效临床工具。
