Study on the consistency of reflux score evaluated by three different level of throat physicians / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The consistency of reflux finding score (RFS) was studied by three different level of throat physicians.</p><p><b>METHODS</b>One hundred and ten laryngeal photos were chosen to assess the RFS test-retest reliability on two separate occasions at least more than one week.</p><p><b>RESULTS</b>The mean total RFS scores for doctor A were 9.05 ± 2.54, doctor B were 8.80 ± 2.20, doctor C were 8.98 ± 2.21 at the initial screening, and 9.20 ± 2.47, 9.03 ± 2.14 and 8.91 ± 2.30 respectively at the repeat evaluation. The test-retest reliability of total RFS scores of three doctors were 0.860, 0.800 and 0.837 respectively, P all <0.001. The test-retest reliability of each item scores for doctor A were from 0.662 to 1.000, doctor B were from 0.486 to 1.000 and doctor C were from 0.613 to 1.000. There were no differences in the total RFS scores comparing among each evaluation of the three doctors (χ(2) = 1.553, P = 0.907). Total RFS scores more than 7 were considered as abnormal. The interobsever consistency was as follows: A with B was 83.6% (κ = 0.617, P = 0.000), A with C was 85.5% (κ = 0.644, P = 0.000),B with C was 89.1% (κ = 0.720, P = 0.000). The intraobserver consistency was 91.8% (κ = 0.807, P = 0.000), 81.8% (κ = 0.534, P = 0.000), 90.9% (κ = 0.741, P = 0.000) respectively.</p><p><b>CONCLUSIONS</b>The result of this study shows that the assessment of RFS is not influenced by different educational backgrounds and clinical experience.RFS can be applied widely in China.</p>

Reliability and validity of the simplified Chinese version of Epworth sleepiness scale / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the reliability and validity of the simplified Chinese version of Epworth sleepiness scale(ESS).</p><p><b>METHODS</b>Five hundred and eighty-five patients with suspected obstructive sleep apnea hypopnea syndrome (OSAHS) and 103 OSAHS patients who underwent operations were included in this study. The ESS was filled before polysomnography (PSG) monitoring under the direction of professional technicians. The patients who underwent operations did both PSG and ESS tests more than 6 months after operation. Fifty-one patients who underwent PSG at our hospital from July to August, 2010 were chosen to assess the ESS test-retest reliability on two separate occasions at least more than one week.</p><p><b>RESULTS</b>The total Cronbach's Alpha of ESS was 0.814. The test-retest reliability of ESS total scores was 0.679 and for each item was from 0.473 to 0.698(P < 0.01). Split-half reliability was 0.817 (P < 0.01). In the analysis of discriminant validity with apnea hypopnea index (AHI), the ESS total scores and each item's scores had significant differences in severity in OSAHS patients and simple snoring patients (P < 0.05), and this was also true in different degrees of lowest saturation of arterial oxygen (LSaO(2)) patients and normal LSaO(2) patients (P < 0.05). The factor analysis of construct validity showed that 4 factors were extracted. The cumulative proportion was 74.270%. The loading was higher than 0.4 among every item. The correlation coefficiency of overall ESS scores and each item's scores was relatively high except the last item. The ESS had low consistency with clinical diagnosis(κ = 0.099, P < 0.01) and the predictive validity was not good (r = 0.138, P < 0.01).As for 103 patients who had operations, the initial assessment of total ESS scores were 15.0[10;20] (M[P(25); P(75)]), and improved to 4[1;6] after operation. The patients who got effective results had significant difference in the total ESS scores before and after operation (Z = -7.528, P < 0.01), so was the patients who got ineffective results (Z = -4.382, P < 0.01) .</p><p><b>CONCLUSIONS</b>The simplified Chinese version of ESS had a good reliability and validity. It can be used to evaluate the chance of dozing in the daytime.</p>