You have accessJournal of UrologyPediatrics: Congenital Anomalies - Lower Urinary Tract & Genitalia II1 Apr 20121608 THE GMS SCORE FOR HYPOSPADIAS PROSPECTIVE ASSESSMENT OF INTER-RATER RELIABILITY Jonathan DeCaro, Lindsey Herrel, Arun Srinivasan, Hal Scherz, Bruce Broecker, Andrew Kirsch, Edwin Smith, Traci Leong, and James Elmore Jonathan DeCaroJonathan DeCaro Atlanta, GA More articles by this author , Lindsey HerrelLindsey Herrel Atlanta, GA More articles by this author , Arun SrinivasanArun Srinivasan Atlanta, GA More articles by this author , Hal ScherzHal Scherz Atlanta, GA More articles by this author , Bruce BroeckerBruce Broecker Atlanta, GA More articles by this author , Andrew KirschAndrew Kirsch Atlanta, GA More articles by this author , Edwin SmithEdwin Smith Atlanta, GA More articles by this author , Traci LeongTraci Leong Atlanta, GA More articles by this author , and James ElmoreJames Elmore Atlanta, GA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1403AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Hypospadias is one of the most common congenital anomalies in boys. While multiple factors appear to effect the outcomes of surgical repair, an objective method to characterize the severity of hypospadias preoperatively has not been established. Herein we present a method for scoring the severity of hypospadias based on the specific anatomical characteristics. As a first step in a prospectively planned multi-part study we determine the inter-observer reliability of the GMS scoring method. METHODS A 3-component method for characterizing hypospadias was developed (Figure). Each component is assigned a value ranging from 1 to 4. The glans (G) score is based on the size of the glans and quality of the urethral plate. The meatus (M) score is based on the location of the meatus. Lastly, the shaft (S) score is based on the severity of chordee. The more unfavorable the characteristic the higher the assigned value. The lowest GMS score possible is 3 (very mild hypospadias) and the highest 12 (severe). Eighty-five consecutive patients (mean age 8.8 months) having primary hypospadias repair were prospectively graded by two surgeons in a blinded fashion using the GMS method. Individual G, M, and S scores as well as total GMS scores were then compared statistically to determine agreement between the raters. Agreement between raters was assessed two ways: (1) using the intraclass correlation coefficient (ICC) and (2) using a weighted kappa. RESULTS G, M, and S scores had substantial to almost perfect agreement among the 2 raters. The ICC ranged from 0.81 to 0.89 and the kappa ranged from 0.75 to 0.83 (Table). Total GMS scores were exactly the same or differed by only one point in 79/85 (92%). CONCLUSIONS The GMS scoring method provides an objective measure of hypospadias severity and has high inter-rater agreement. The scoring method may be useful in discussions and research related to hypospadias. Further study is ongoing to determine if the GMS score correlates to surgical outcomes. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e650-e651 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jonathan DeCaro Atlanta, GA More articles by this author Lindsey Herrel Atlanta, GA More articles by this author Arun Srinivasan Atlanta, GA More articles by this author Hal Scherz Atlanta, GA More articles by this author Bruce Broecker Atlanta, GA More articles by this author Andrew Kirsch Atlanta, GA More articles by this author Edwin Smith Atlanta, GA More articles by this author Traci Leong Atlanta, GA More articles by this author James Elmore Atlanta, GA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...