• Annals of surgery · Aug 2024

    Interobserver Variability in the International Study Group for Pancreas Surgery (ISGPS)-Defined Complications After Pancreatoduodenectomy: An International Cross-Sectional Multicenter Study.

    • Tessa E Hendriks, Alberto Balduzzi, Susan van Dieren, J Annelie Suurmeijer, Roberto Salvia, Thomas F Stoop, Marco Del Chiaro, Sven D Mieog, Mark Nielen, Sabino Zani, Daniel Nussbaum, Thilo Hackert, Jakob R Izbicki, Ammar A Javed, D Brock Hewitt, KoerkampBas GrootBGDepartment of surgery, Erasmus University Medical Center, Rotterdam, the Netherlands., Roeland F de Wilde, Yi Miao, Kuirong Jiang, Kohei Nakata, Masafumi Nakamura, Jin-Young Jang, Mirang Lee, Cristina R Ferrone, Shailesh V Shrikhande, Vikram A Chaudhari, Olivier R Busch, Ajith K Siriwardena, Oliver Strobel, Jens Werner, Bert A Bonsing, Giovanni Marchegiani, Marc G Besselink, and International Study Group for Pancreatic Surgery (ISGPS).
    • Amsterdam UMC, location University of Amsterdam, Department of Surgery Amsterdam, the Netherlands.
    • Ann. Surg. 2024 Aug 1.

    ObjectiveTo determine the interobserver variability for complications of pancreatoduodenectomy as defined by the International Study Group for Pancreatic Surgery (ISGPS) and others.Summary Background DataGood interobserver variability for the definitions of surgical complications is of major importance in comparing surgical outcomes between and within centers. However, data on interobserver variability for pancreatoduodenectomy-specific complications are lacking.MethodsInternational cross-sectional multicenter study including 52 raters from 13 high-volume pancreatic centers in 8 countries on 3 continents. Per center, 4 experienced raters scored 30 randomly selected patients after pancreatoduodenectomy. In addition, all raters scored six standardized case vignettes. This variability and the 'within centers' variability were calculated for twofold scoring (no complication/grade A vs grade B/C) and threefold scoring (no complication/grade A vs grade B vs grade C) of postoperative pancreatic fistula (POPF), post-pancreatoduodenectomy hemorrhage (PPH), chyle leak (CL), bile leak (BL), and delayed gastric emptying (DGE). Interobserver variability is presented with Gwet's AC-1 measure for agreement.ResultsOverall, 390 patients after pancreatoduodenectomy were included. The overall agreement rate for the standardized cases vignettes for twofold scoring was 68% (95%-CI: 55%-81%, AC1 score: moderate agreement) and for threefold scoring 55% (49%-62%, AC1 score: fair agreement). The mean 'within centers' agreement for twofold scoring was 84% (80%-87%, AC1 score; substantial agreement).ConclusionThe interobserver variability for the ISGPS defined complications of pancreatoduodenectomy was too high even though the 'within centers' agreement was acceptable. Since these findings will decrease the quality and validity of clinical studies, ISGPS has started efforts aimed at reducing the interobserver variability.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…