Reliability of Oronasal Fistula Classification

Author:

Sitzman Thomas J.,Allori Alexander C.,Matic Damir B.,Beals Stephen P.,Fisher David M.,Samson Thomas D.,Marcus Jeffrey R.,Tse Raymond W.,

Abstract

Objective: Oronasal fistula is an important complication of cleft palate repair that is frequently used to evaluate surgical quality, yet reliability of fistula classification has never been examined. The objective of this study was to determine the reliability of oronasal fistula classification both within individual surgeons and between multiple surgeons. Design: Using intraoral photographs of children with repaired cleft palate, surgeons rated the location of palatal fistulae using the Pittsburgh Fistula Classification System. Intrarater and interrater reliability scores were calculated for each region of the palate. Participants: Eight cleft surgeons rated photographs obtained from 29 children. Results: Within individual surgeons reliability for each region of the Pittsburgh classification ranged from moderate to almost perfect (κ = .60-.96). By contrast, reliability between surgeons was lower, ranging from fair to substantial (κ = .23-.70). Between-surgeon reliability was lowest for the junction of the soft and hard palates (κ = .23). Within-surgeon and between-surgeon reliability were almost perfect for the more general classification of fistula in the secondary palate (κ = .95 and κ = .83, respectively). Conclusions: This is the first reliability study of fistula classification. We show that the Pittsburgh Fistula Classification System is reliable when used by an individual surgeon, but less reliable when used among multiple surgeons. Comparisons of fistula occurrence among surgeons may be subject to less bias if they use the more general classification of “presence or absence of fistula of the secondary palate” rather than the Pittsburgh Fistula Classification System.

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Oral Surgery

Cited by 10 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Practice-based Evidence from Comparative Effectiveness Research to Inform Evidence-based Practice;The Cleft Palate Craniofacial Journal;2023-08-30

2. Unraveling a Major Burden of Orofacial Clefts Analyses: Classification of Cleft Palate Fistulas by Cleft Surgeons;The Cleft Palate Craniofacial Journal;2023-01-03

3. Evaluation of a Novel Technique for Closure of Small Palatal Fistula;Journal of Personalized Medicine;2022-12-28

4. Previous Classifications for Palatal Fistulae;Surgical Atlas of Cleft Palate and Palatal Fistulae;2022

5. Previous Classifications for Palatal Fistulae;Surgical Atlas of Cleft Palate and Palatal Fistulae;2022

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