title: Interrater reliability of the International Continence Society and International Urogynecological Association (ICS/IUGA) classification system for mesh-related complications.
abstract: OBJECTIVE
  We sought to assess interrater reliability of the International Continence Society (ICS)/International Urogynecological Association (IUGA) classification system of vaginal mesh-related complications and compare this with several other available complication classification systems.
  
  
  METHODS
  This was a retrospective analysis of mesh-related complications in patients presenting after pelvic organ prolapse or incontinence surgery. The complications were classified by 2 independent reviewers using the ICS/IUGA classification system as well as 3 other available classification systems. Interrater reliability was assessed using percent agreement and the weighted κ statistic.
  
  
  RESULTS
  The ICS/IUGA mesh complication classification system was found to have poor interrater reliability (κ = 0.15-0.78). The other systems yielded a κ that ranged from 0.18-0.60, but were too general or could only be applied to 68% of the complications.
  
  
  CONCLUSIONS
  The complexity of the ICS/IUGA mesh complication system, the large number of categories, and lack of clarity likely contribute to its poor interrater reliability.
authors.affiliation: Female Pelvic Medicine & Reconstructive Surgery Obstetrics, Gynecology and Women's Health Institute at Cleveland Clinic, Cleveland, OH 44195, USA. tunitse@ccf.org
authors.forename: Elena
authors.initials: E
authors.lastname: Tunitsky
authors.forename: Sara
authors.initials: S
authors.lastname: Abbott
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Barber
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation*; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000145:classification*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012955:Societies, Medical; D013526:Surgical Mesh; D009626:Terminology as Topic; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000601:surgery