Interobserver variability of Clavien–Dindo scoring in urology. (15th July 2014)

• Record Type: Journal Article
• Authors: Poletajew, Sławomir; Zapała, Łukasz; Piotrowicz, Sebastian; Wołyniec, Paweł; Sochaj, Marta; Buraczyński, Paweł; Lisiński, Janusz; Świniarski, Piotr; Radziszewski, Piotr; Residents Section of Polish Urological Association
• Is Part Of: International journal of urology. Volume 21:Number 12(2014)
• Page Start: 1274
• Page End: 1278
• Publication Date: 2014-07-15
• Subjects: Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.12576
• Languages: English
• ISSNs: 0919-8172

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="iju12576-sec-0001" sec-type="section"> <title>Objectives</title> <p>To assess the interobserver variability of Clavien–Dindo scoring in urology.</p> </sec> <sec id="iju12576-sec-0002" sec-type="section"> <title>Methods</title> <p>A thematic survey was carried out simultaneously in nine Polish urological centers among 171 responders – 81 urologists and 90 urologists‐in‐training, made up of 16 women and 155 men. After Clavien–Dindo classification was presented, respondents were asked to grade nine typical urological complications according to Clavien–Dindo classification. Interobserver agreement, reproducibility of answers, as well as the influencing factors were analyzed. Questions in the survey related to complications of variable severity after basic urological operations, including four open, one laparoscopic and four endourological.</p> </sec> <sec id="iju12576-sec-0003" sec-type="section"> <title>Results</title> <p>Agreement on the grade of complication was moderate (κ = 0.45) and it was noticed in 69% of respondents (range 38–87%). No effect of surgical approach (classic <italic>vs</italic> endoscopic, 70% <italic>vs</italic> 67%, <italic>P</italic> = 0.64), or physician professional experience (resident <italic>vs</italic> urologist, 71% <italic>vs</italic> 66%, <italic>P</italic> = 0.77) was observed. The most significant discrepancies were found in cases of local complications after transurethral surgery (accordance in 39%) and laparoscopic radical prostatectomy (accordance in 55%), and in cases of severe general complications after Bricker operation (accordance in 58%).</p> </sec> <sec id="iju12576-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The variability of Clavien–Dindo classification scoring among urologists is significant. Thus, the Clavien–Dindo classification might require detailing before its eventual implementation in urology, together with appropriate training of specialists. However, despite some disadvantages, the simplicity, reproducibility and logical scheme of the Clavien–Dindo classification make it a promising tool for quality assessment in different fields of urology.</p> </sec> </abstract>