![]() Hence, this creates a growing divergence in surgical treatment planning and treatment outcome. The classification and assessment of clinical findings based on DISE is highly subjective due to the increasing number of DISE classification systems. None of the studies were based on randomised control trials.ĭISE is an objective method for visualising upper airway obstruction. The third objective is to identify if there is one DISE grading and classification treatment outcome framework for determining the likelihood of success for a given OSA surgical intervention.Ī systematic review was performed to identify new and significantly modified DISE classification systems: concept, advantages and disadvantages.įourteen studies proposing a new DISE classification system and three studies proposing a significantly modified DISE classification were identified. The second objective is to identify if there is one DISE grading and classification treatment planning framework for deciding appropriate surgical treatment for obstructive sleep apnoea (OSA). The first objective is to identify if there is a universally accepted DISE grading and classification system for analysing DISE findings. Our novel scoring system demonstrated intra-rater test-retest and inter-rater reliability similar to the VOTE system, includes more sites of potential airway obstruction, and has potential for widespread use.ĭrug-induced sedation endoscopy (DISE) classification systems have been used to assess anatomical findings on upper airway obstruction, and decide and plan surgical treatments and act as a predictor for surgical treatment outcome for obstructive sleep apnoea management. 15), but significant difference on PA (p =. There was no significant difference between the 2 scoring systems on the WK statistic (p =. KA was 0.40 and 0.61 at the 25th and 75th percentiles, respectively. In addition, responses to the surgical intervention survey analysis yielded a test-retest WK coefficient of 0.40 and 1.00 and a PA 71%–100% at the 25th and 75th percentiles, respectively. KA was 0.36 and 0.77 at the 25th and 75th percentiles. For the VOTE system, the intra-rater test-retest WK coefficient was 0.50 and 1.00 and PA was 75% and 100% at the 25th and 75th percentiles, respectively. Using a proportional odds model, a comparison of the weighted kappa statistic for the VOTE and the novel scoring systems was conducted.įor the novel scoring system, the intra-rater test-retest WK coefficient was 0.62 and 0.87 and the PA was 64% and 82% at the 25th and 75th percentiles, respectively. Inter-rater reliability analysis of responses was evaluated using Krippendorff's alpha reliability coefficient (KA). ![]() Intra-rater test-retest analysis of the responses was conducted using weighted kappa (WK) statistic and percentage agreement (PA), respectively. The raters were also asked to recommend surgical intervention based on the DISE exam alone. The videos were scored using both the VOTE and the new scoring systems. The purpose of this study is to compare a novel system to the more commonly used VOTE (Velum, Oropharynx, Tongue base, Epiglottis) system.Ī total of thirty pediatric DISE videos were reviewed and scored twice by 5 raters with a range of experience levels. ![]() The surgical management of Obstructive Sleep Apnea (OSA) may be guided by Drug Induced Sleep Endoscopy (DISE), but there is no universally accepted scoring system for DISE in children.
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