Study on the reproducibility of the Waters' views of the maxillary sinuses.
OBJECTIVE
This study intended to investigate the reproducibility of the Waters' view for maxillary sinusitis and to define its place in clinical practice.


METHODS
Radiographs of 80 maxillary sinuses of patients with suspected acute sinusitis were read by 6 radiologists, 6 ENT surgeons, 6 general practitioners (GPs). Interobserver agreement was calculated using the kappa statistic.


RESULTS
Agreement was good (kappa = 0.63; 95% CI 0.58-0.68) between radiologists when the criteria used to define acute sinusitis were "important mucosal swelling, air-fluid level or complete opacity". When the criteria "air-fluid level or complete opacity" were used, agreement was fair (kappa 0.39; 95% CI 0.35-0.44). Between ENT-surgeons kappas were respectively 0.58 (95% CI 0.53-0.63) and 0.37 (95% CI 0.32-0.42). Between GPs kappas were respectively 0.30 (95% CI 0.25-0.35) and 0.28 (95% CI 0.23-0.33).


CONCLUSIONS
The reproducibility of Waters' views of the maxillary sinuses is best when the interpretation is performed by radiologists or ENT surgeons, and when criteria for sinusitis are: important mucosal swelling, air fluid level or complete opacity. The good interobserver agreement combined with the known high negative predictive value of these diagnostic criteria makes the Waters' view only useful for ruling out acute sinusitis.
De Sutter
An
A
Department of General Practice and Primary Health Care, Ghent University, De Pintelaan 185, 9000 Gent, Belgium. an.desutter@UGent.be
Spee
Ruud
R
Peersman
Wim
W
De Meyere
Marc
M
Van Cauwenberge
Paul
P
Verstraete
Koenraad
K
De Maeseneer
Jan
J
D006801:Humans; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging*; D015588:Observer Variation; D011859:Radiography; D015203:Reproducibility of Results