Reliability Assessment of Society for Fetal Urology Ultrasound Grading System for Hydronephrosis

No AccessJournal of UrologyKidney/Hydronephrosis1 Oct 2008Reliability Assessment of Society for Fetal Urology Ultrasound Grading System for Hydronephrosis M.A. Keays, L.A. Guerra, J. Mihill, G. Raju, N. Al-Asheeri, P. Geier, I. Gaboury, M. Matzinger, J. Pike, and M.P. Leonard M.A. KeaysM.A. Keays Division of Pediatric Urology, University of Ottawa, Ontario, Canada , L.A. GuerraL.A. Guerra Division of Pediatric Urology, University of Ottawa, Ontario, Canada , J. MihillJ. Mihill Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ontario, Canada , G. RajuG. Raju Division of Pediatric Urology, University of Ottawa, Ontario, Canada , N. Al-AsheeriN. Al-Asheeri Division of Pediatric Urology, University of Ottawa, Ontario, Canada , P. GeierP. Geier Division of Nephrology, University of Ottawa, Ontario, Canada , I. GabouryI. Gaboury Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ontario, Canada , M. MatzingerM. Matzinger Department of Pediatric Radiology, University of Ottawa, Ontario, Canada , J. PikeJ. Pike Division of Pediatric Urology, University of Ottawa, Ontario, Canada , and M.P. LeonardM.P. Leonard Division of Pediatric Urology, University of Ottawa, Ontario, Canada View All Author Informationhttps://doi.org/10.1016/j.juro.2008.03.107AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The Society for Fetal Urology introduced a subjective grading system for classifying hydronephrosis that has important implications in patient diagnosis, treatment and outcome. The grading system is frequently used to standardize the severity of hydronephrosis, and compare results among patients and centers. Despite widespread use to our knowledge no groups have investigated the reliability of the grading system since its introduction. We assessed the intrarater and interrater reliability of the Society for Fetal Urology grading system for hydronephrosis and examined levels of agreement by the degree of hydronephrosis (grades 0 to 4) and level of experience (staff vs trainee). Materials and Methods: A series of 50 pediatric renal ultrasound images from patients with a diagnosis of hydronephrosis were assessed by 4 staff individuals and 4 trainees using the Society for Fetal Urology grading system. Ultrasound images included the kidneys, ureters and bladder to be consistent with practice. After 7 to 14 days each rater repeated the assessment. The nonweighted Cohen κ statistic was used to estimate intrarater and interrater reliability by Society for Fetal Urology grade and training level. Results: Staff and trainee raters independently assigned Society for Fetal Urology grades to 50 patients (99 renal units). The average number of images per ultrasound was 41, including the right and left kidneys. Overall interrater agreement for staff individuals was substantial for grade 0, moderate for grades 1, 2 and 4, and only slight to fair for grade 3. Intrarater agreement was substantial to almost perfect for staff agreement (range 69% to 94%, κ 0.56 to 0.89) and trainees (range 63% to 90%, κ 0.48 to 0.85). Conclusions: Our study suggests that the Society for Fetal Urology grading system has good intrarater but modest interrater reliability. Individual rater interpretations of the grading system may explain the modest interrater agreement. Proposed modifications to the Society for Fetal Urology classification system, such as distinguishing between diffuse and segmental cortical thinning, may improve reliability. References 1 : Clinical relevance and implications of antenatal hydronephrosis. Arch Dis Child Fetal Neonatal Ed1997; 76: F31. Google Scholar 2 : Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatr Radiol1993; 23: 478. 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Google Scholar © 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byMelo F, Mak R, Simões e Silva A, Vasconcelos M, Dias C, Rosa L, Shiomatsu G, Storch C, Oliveira M and Oliveira E (2021) Evaluation of Urinary Tract Dilation Classification System for Prediction of Long-Term Outcomes in Isolated Antenatal Hydronephrosis: A Cohort StudyJournal of Urology, VOL. 206, NO. 4, (1022-1030), Online publication date: 1-Oct-2021.Jung J, Lee J, Kim K and Park Y (2020) Utility of Society for Fetal Urology and Anteroposterior Pelvic Diameter Grading Systems for Estimating Time to Resolution of Isolated Hydronephrosis: A Single Center StudyJournal of Urology, VOL. 204, NO. 5, (1048-1053), Online publication date: 1-Nov-2020.Jacobson D, Flink C, Johnson E, Maizels M, Yerkes E, Lindgren B, Liu D, Rosoklija I, Cheng E and Gong E (2018) The Correlation between Serial Ultrasound and Diuretic Renography in Children with Severe Unilateral HydronephrosisJournal of Urology, VOL. 200, NO. 2, (440-447), Online publication date: 1-Aug-2018.Braga L, McGrath M, Farrokhyar F, Jegatheeswaran K and Lorenzo A (2017) Society for Fetal Urology Classification vs Urinary Tract Dilation Grading System for Prognostication in Prenatal Hydronephrosis: A Time to Resolution AnalysisJournal of Urology, VOL. 199, NO. 6, (1615-1621), Online publication date: 1-Jun-2018.Scalabre A, Demède D, Gaillard S, Pracros J, Mouriquand P and Mure P (2016) Prognostic Value of Ultrasound Grading Systems in Prenatally Diagnosed Unilateral Urinary Tract DilatationJournal of Urology, VOL. 197, NO. 4, (1144-1149), Online publication date: 1-Apr-2017.Braga L, McGrath M, Farrokhyar F, Jegatheeswaran K and Lorenzo A (2016) Associations of Initial Society for Fetal Urology Grades and Urinary Tract Dilatation Risk Groups with Clinical Outcomes in Patients with Isolated Prenatal HydronephrosisJournal of Urology, VOL. 197, NO. 3 Part 2, (831-837), Online publication date: 1-Mar-2017.Cerrolaza J, Peters C, Martin A, Myers E, Safdar N and Linguraru M (2015) Quantitative Ultrasound for Measuring Obstructive Severity in Children with HydronephrosisJournal of Urology, VOL. 195, NO. 4 Part 1, (1093-1099), Online publication date: 1-Apr-2016.Hodhod A, Capolicchio J, Jednak R, El-Sherif E, El-Doray A and El-Sherbiny M (2015) Evaluation of Urinary Tract Dilation Classification System for Grading Postnatal HydronephrosisJournal of Urology, VOL. 195, NO. 3, (725-730), Online publication date: 1-Mar-2016.Sancaktutar A, Adanur Ş, Reşorlu B, Tepeler A, Ziypak T, Söylemez H, Atar M, Bozkurt Y, Penbegül N, Tüfek A and Yavuz S (2012) The Forgotten Ureteral Stent in Children: From Diagnosis to TreatmentJournal of Urology, VOL. 189, NO. 3, (1054-1060), Online publication date: 1-Mar-2013.Wong L, Chum J, Maddy P, Chan S, Travis D and Lawrentschuk N (2010) Creation and Validation of a Visual Macroscopic Hematuria Scale for Optimal Communication and an Objective Hematuria IndexJournal of Urology, VOL. 184, NO. 1, (231-236), Online publication date: 1-Jul-2010.Copp H (2009) Are We All Talking About the Same Thing?Journal of Urology, VOL. 182, NO. 1, (12-13), Online publication date: 1-Jul-2009. Volume 180Issue 4SOctober 2008Page: 1680-1683 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordskidneyhydronephrosisultrasonographydiagnosisreproducibility of resultsMetricsAuthor Information M.A. Keays Division of Pediatric Urology, University of Ottawa, Ontario, Canada More articles by this author L.A. Guerra Division of Pediatric Urology, University of Ottawa, Ontario, Canada More articles by this author J. Mihill Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ontario, Canada More articles by this author G. Raju Division of Pediatric Urology, University of Ottawa, Ontario, Canada More articles by this author N. Al-Asheeri Division of Pediatric Urology, University of Ottawa, Ontario, Canada More articles by this author P. Geier Division of Nephrology, University of Ottawa, Ontario, Canada More articles by this author I. Gaboury Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ontario, Canada More articles by this author M. Matzinger Department of Pediatric Radiology, University of Ottawa, Ontario, Canada More articles by this author J. Pike Division of Pediatric Urology, University of Ottawa, Ontario, Canada More articles by this author M.P. Leonard Division of Pediatric Urology, University of Ottawa, Ontario, Canada More articles by this author Expand All Advertisement PDF downloadLoading ...