A COMPARISON OF SINUS COMPUTED-TOMOGRAPHY (CT) STAGING SYSTEMS FOR OUTCOMES RESEARCH

The success of outcomes research for sinus disease will depend in part on the utilization of a computed tomography (CT) staging system that meets rigorous statistical criteria. Such a staging system must demons trate an even distribution of population by scale, a high inter-rater and intra-rater agreement, and a low percentage of unclassifiable scan s. Four proposed sinus CT classification systems were evaluated for th ese parameters. Each system was used by four masked racers to rate 42 consecutive preoperative CT scans on two separate occasions. One of th ese systems is based on the sire of disease rather than the degree of sinus opacification and gives a clear definition of sinus disease (2 m m or greater of mucosal thickening). This system had the highest inter -rater agreement (kappa = 0.61, range = 0.38 to 0.61) and the lowest p ercentage of unclassifiable scans (0.6%, range = 0.6 to 14.2%). The st atistical attributes of this particular sinus CT staging system suppor t its use for outcomes research in sinus disease.