Gender and intra-observer agreement about laryngoscopy of papilloma

Abstract

Background: The gender of the observer may bias data. Objective: Compare the intra-observer agreements of male and female pediatric otolaryngologists about videotaped images of laryngeal papilloma. Design: Five male and six female pediatric otolaryngologists independently viewed videotapes of ten children undergoing treatment for laryngeal papilloma. Each of 12 anatomic sites was categorized as disease present, absent, or indeterminate. Each observer estimated the percent overall airway obstruction. 5–24 weeks later, each observer repeated his/her assessments. Results: The mean intra-observer agreements for both male and female pediatric otolaryngologists were good, and identical ( κ 0.63; proportion of positive agreement 0.82; proportion of negative agreement 0.72). Females more frequently categorized a site as indeterminate. Males more frequently categorized a site oppositely on repeat assessment. The males’ indeterminate/opposite ratio was less than that of the females’ ( P=0.03). Intra-observer estimates of overall airway obstruction have wide variability: for male pediatric otolaryngologists, differences exceeding 30% are significant; for females, 40%. Conclusions: Male and female pediatric otolaryngologists had equally good and identical intra-observer κ scores and proportions of positive and negative agreement. However, males used the indeterminate category less than did the females, and males more often gave an opposite categorization at the second viewing session. Estimates of overall airway obstruction have much intra-observer variability.