A grading scale for pediatric vocal fold nodules.

Abstract

To design a grading scale for vocal fold nodules in pediatric patients. We conducted a prospective study in which a grading scale for vocal nodule size and contour based on static fiberoptic images of pediatric larynges was developed to achieve the scale presented here. Twenty-eight health care professionals each rated 28 images of pediatric vocal fold nodules. The intraclass correlation for nodule size was strong (0.77; 95% confidence interval, 0.67-0.87). The kappa statistic for nodule contour was mild (0.35; 95% confidence interval, 0.33-0.37). Agreement between experienced and other raters found no significant difference for the nodule size or contour grade of a given image. A grading scale for pediatric vocal fold nodules is presented. Interrater reliability for nodule size is high and can be reliably used by health care professionals with varying levels of experience. A validated grading scale facilitates objective analysis of outcomes when studying and following patients with vocal nodules.