title: Validation of a new grading system for endoscopic examination of adenoid hypertrophy.
abstract: OBJECTIVE
  To propose and validate a new subjective grading system of adenoid size with flexible fiberoptic evaluation.
  
  
  METHODS
  Digital video clips of 24 flexible fiberoptic nasopharyngeal exams were presented to 24 examiners (otolaryngology resident and consultant physicians) at a tertiary care institution. Examiners were asked to use the proposed grading system to rate adenoid hypertrophy. Kappa statistical analysis was used to evaluate the degree of intergrader agreement or disagreement.
  
  
  RESULTS
  Statistical analysis of intergrader agreement demonstrated an overall Kappa score of 0.71 suggesting a "substantial" strength of agreement. The Kappa strength of agreement was found to be 0.83 (almost perfect) among consultant physicians and 0.62 (substantial) among resident physicians.
  
  
  CONCLUSIONS
  The proposed adenoid staging system is a reliable and consistent method of staging adenoid tissue size.
  
  
  CONCLUSIONS
  This new validated grading system may be a useful standard for reporting adenoid size in future clinical outcome studies.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, New York, New York, USA. sparikh@montefiore.org
authors.forename: Sanjay R
authors.initials: SR
authors.lastname: Parikh
authors.forename: Mark
authors.initials: M
authors.lastname: Coronel
authors.forename: James J
authors.initials: JJ
authors.lastname: Lee
authors.forename: Seth M
authors.initials: SM
authors.lastname: Brown
mesh_terms: D000234:Adenoids / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005336:Fiber Optic Technology; D006801:Humans; D006984:Hypertrophy; D007223:Infant; D008875:Middle Aged; D015588:Observer Variation