Intra-rater and Inter-rater consistency of drug induced sleep endoscopy

Objective: Drug induced sleep endoscopy (DISE) is a valuable tool which is used in the diagnosis of obstructive sleep apnea (OUA). The aim of this study is to evaluate inter-rater and intra-rater consistency of DISE.

Methods: 36 OSA patients with Apnea-hypopne index>5 included in this study. DISE was performed and recorded digitally for all patients, by the first author (OA1). VOTE scores were noted to procedure report in patients’ charts. Video records of DISE were blindly evaluated six months after the last procedure, by observer 1 for the second time (OA2) and by observer 2 (OB) for the first time. DISE was evaluated by using VOTE classification. OA1 and OA2 scores were compared to determine intra-rater reliability and OA2 and OB scores were compared to determine inter-rater reliability.

Results: Inter-rater consistency of DISE was poor to good. Highest consistency rate was found in velum at anteroposterior configuration, while the lowest was found in the same level at lateral configuration. Intra-rater consistency of DISE was moderate to excellent. Highest consistency rate was found in epiglottis at lateral configuration, while the lowest was found in oropharynx level.

Conclusion: OSA is condition with possible serious complications. DISE is a tool that could change the course of treatment in OSA. The validity of DISE is quite acceptable although a golden standard classification tool could enable us to “speak the exact same language” and will surely increase the diagnostic success of DISE.