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Interrater reliability of the International Continence Society and International Urogynecological Association (ICS/IUGA) classification system for mesh-related complications

Authors
Journal
American Journal of Obstetrics and Gynecology
0002-9378
Publisher
Elsevier
Volume
206
Issue
5
Identifiers
DOI: 10.1016/j.ajog.2012.03.004
Keywords
  • Classification System
  • Interrater Reliability
  • Pelvic Organ Prolapse
  • Synthetic Mesh
  • Vaginal Mesh Complications
Disciplines
  • Ecology
  • Medicine

Abstract

Objective We sought to assess interrater reliability of the International Continence Society (ICS)/International Urogynecological Association (IUGA) classification system of vaginal mesh-related complications and compare this with several other available complication classification systems. Study Design This was a retrospective analysis of mesh-related complications in patients presenting after pelvic organ prolapse or incontinence surgery. The complications were classified by 2 independent reviewers using the ICS/IUGA classification system as well as 3 other available classification systems. Interrater reliability was assessed using percent agreement and the weighted κ statistic. Results The ICS/IUGA mesh complication classification system was found to have poor interrater reliability (κ = 0.15-0.78). The other systems yielded a κ that ranged from 0.18-0.60, but were too general or could only be applied to 68% of the complications. Conclusion The complexity of the ICS/IUGA mesh complication system, the large number of categories, and lack of clarity likely contribute to its poor interrater reliability.

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