Abstract
Objectives: To externally validate the reliability of the Reflux Finding Score (RFS), a recently published laryngeal grading system, in a cohort of subjects with chronic laryngopharyngitis thought secondary to acid reflux disease.
Methods: Two blinded otolaryngologists independently graded 66 videostrobe laryngeal examinations of 33 patients with chronic symptoms of laryngopharyngitis before and 2 months after treatment. The raters evaluated the examinations on 2 separate occasions at least 24 hours apart, blinded to the previous evaluation. Linear correlation was performed to assess inter- and intrarater reliability using the total reflux finding score.
Results: Intrarater reliability was very good for both raters for the total reflux finding score (r = 0.87, P < 0.0001, intercept P = 0.37; and r = 0.93, P < 0.0001, intercept P = 0.51). Interrater reliability was also good between raters (r = 0.71, P < 0.0001) but raised the possibility of bias between raters (intercept = 2.4, std error = 1.4, P = 0.08). Among the individual component scores for interrater reliability, true vocal fold edema demonstrated good correlation without bias, while diffuse laryngeal edema and posterior commisure hypertrophy demonstrated good correlation with significant interrater bias. Ventricular obstruction demonstrated moderate correlation with significant bias. Thick endolaryngeal mucous demonstrated fair correlation and subglottic edema poor correlation. Granuloma showed no correlation due to low prevalence.
Conclusions: The total reflux finding score demonstrates very good intrarater and good interrater correlation in this cohort of subjects with symptoms of chronic laryngopharyn-gitis. Individual component scores demonstrate variable cor-relation and significant bias between raters.
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