title: The GMS hypospadias score: assessment of inter-observer reliability and correlation with post-operative complications.
abstract: OBJECTIVE
  An agreed upon method for describing the severity of hypospadias has not been established. Herein we assess the inter-observer reliability of the GMS hypospadias score and correlate it with the risk of a post-operative complication.
  
  
  METHODS
  A 3-component method for grading the severity of hypospadias was developed (GMS). Eighty-five consecutive patients presenting for hypospadias repair were graded independently by at least 2 surgeons using the GMS criteria. Scores were compared statistically to determine agreement between the observers. The outcomes of these patients were then reviewed to determine how the GMS score correlates to the risk of a surgical complication.
  
  
  RESULTS
  The G, M, and S scores had excellent agreement between observers. The GMS total score was exactly the same or differed by one point in 79/85 (93%) of patients. The complication rate was 5.6% for patients with a GMS score of 6 or less, but was 25.0% for patients with a GMS score greater than 6.
  
  
  CONCLUSIONS
  The GMS score provides a concise method for describing the severity of hypospadias and appears to have high inter-observer reliability. The GMS score also appears to correlate with the risk of a surgical complication.
authors.affiliation: Department of Urology, Children's Healthcare of Atlanta, Emory University School of Medicine, Georgia Pediatric Urology, Atlanta, GA, USA.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Merriman
authors.forename: Angela M
authors.initials: AM
authors.lastname: Arlen
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Broecker
authors.forename: Edwin A
authors.initials: EA
authors.lastname: Smith
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Kirsch
authors.forename: James M
authors.initials: JM
authors.lastname: Elmore
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D007223:Infant; D008297:Male; D015588:Observer Variation; D010413:Penis / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000473:pathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D014521:Urethra / Q000473:pathology / Q000601:surgery; D013521:Urologic Surgical Procedures, Male / Q000379:methods / Q000706:statistics & numerical data*
keywords: Children; Chordee; Complications; Grade; Hypospadias; Score