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

Autor:	Hendriks TE; Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam the Netherlands.; Cancer Center Amsterdam, the Netherlands.; Dutch institute for Clinical Auditing, Leiden, the Netherlands.; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands., Balduzzi A; Unit of General and Pancreatic Surgery, Department of Surgery, Dentistry, Paediatrics and Gynaecology, The Pancreas Institute Verona, University of Verona, Verona, Italy., van Dieren S; Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam the Netherlands.; Cancer Center Amsterdam, the Netherlands., Suurmeijer JA; Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam the Netherlands.; Cancer Center Amsterdam, the Netherlands., Salvia R; Unit of General and Pancreatic Surgery, Department of Surgery, Dentistry, Paediatrics and Gynaecology, The Pancreas Institute Verona, University of Verona, Verona, Italy., Stoop TF; Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam the Netherlands.; Cancer Center Amsterdam, the Netherlands.; Department of Surgery, Division of Surgical Oncology, University of Colorado Anschutz Medical Campus, Aurora, CO., Del Chiaro M; Department of Surgery, Division of Surgical Oncology, University of Colorado Anschutz Medical Campus, Aurora, CO., Mieog SD; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands., Nielen M; Dutch institute for Clinical Auditing, Leiden, the Netherlands., Zani S Jr; Department of surgery, Duke University, Durham, NC., Nussbaum D; Department of surgery, Duke University, Durham, NC., Hackert T; Department of General Visceral and Thoracic Surgery University Hospital Hamburg-Eppendorf, Germany., Izbicki JR; Department of General Visceral and Thoracic Surgery University Hospital Hamburg-Eppendorf, Germany., Javed AA; Department of Surgery, New York University Langone Health, New York, NY., Hewitt DB; Department of Surgery, New York University Langone Health, New York, NY., Koerkamp BG; Department of surgery, Erasmus University Medical Center, Rotterdam, the Netherlands., de Wilde RF; Department of surgery, Erasmus University Medical Center, Rotterdam, the Netherlands., Miao Y; Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, China., Jiang K; Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, China., Nakata K; Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Nakamura M; Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Jang JY; Department of Surgery, Seoul National University Center, Seoul, Korea., Lee M; Department of Surgery, Seoul National University Center, Seoul, Korea., Ferrone CR; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Shrikhande SV; Department of Gastrointestinal Surgical Oncology, Tata Memorial Hospital, Mumbai, India., Chaudhari VA; Department of Gastrointestinal Surgical Oncology, Tata Memorial Hospital, Mumbai, India., Busch OR; Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam the Netherlands.; Cancer Center Amsterdam, the Netherlands., Siriwardena AK; Hepatobiliary and Pancreatic Surgery Unit, Manchester Royal Infirmary, Manchester University NHS FT, Manchester, United Kingdom., Strobel O; Department of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, Austria., Werner J; Department of General, Visceral and Transplant Surgery, University Hospital, LMU Munich, Munich, Germany., Bonsing BA; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands., Marchegiani G; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Padua, Italy., Besselink MG; Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam the Netherlands.; Cancer Center Amsterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2024 Nov 01; Vol. 280 (5), pp. 728-733. Date of Electronic Publication: 2024 Aug 01.
DOI:	10.1097/SLA.0000000000006473
Abstrakt:	Objective: To determine the interobserver variability for complications of pancreatoduodenectomy as defined by the International Study Group for Pancreatic Surgery (ISGPS) and others. Background: Good 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. Methods: International 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 6 standardized case vignettes. This variability and the "within centers" variability were calculated for 2-fold scoring (no complication/grade A vs grade B/C) and 3-fold scoring (no complication/grade A vs grade B vs grade C) of postoperative pancreatic fistula, postpancreatoduodenectomy hemorrhage, chyle leak, bile leak, and delayed gastric emptying. Interobserver variability is presented with Gwet AC-1 measure for agreement. Results: Overall, 390 patients after pancreatoduodenectomy were included. The overall agreement rate for the standardized cases vignettes for 2-fold scoring was 68% (95% CI: 55%-81%, AC1 score: moderate agreement), and for 3-fold scoring 55% (49%-62%, AC1 score: fair agreement). The mean "within centers" agreement for 2-fold scoring was 84% (80%-87%, AC1 score; substantial agreement). Conclusions: The 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. Competing Interests: The authors report no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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