Is the Goligher classification a valid tool in clinical practice and research for hemorrhoidal disease?

• DOI: 10.1007/s10151-022-02591-3
• Publication Date: 2022-02-09T19:03:31Z
• Authors: L. Dekker; I. J. M. Han-Geurts; U. Grossi; G. Gallo; R. Veldkamp
• Keywords: Cohen's kappa; Kappa; Clinical Practice

The most widely used classification for hemorrhoidal disease (HD) is the Goligher classification, which ranks presence and severity of prolapse in four grades. Since physicians base this gradation on medical history physical examination, it might be prone to interobserver variability. Furthermore, impacts treatment choice makes reproducibility utmost importance. aim study was determine variability among surgeons Netherlands.A single-choice survey used. first part consisted questions concerning baseline characteristics use routine clinical practice. In second part, assess variability, we asked gastrointestinal residents who routinely treat HD review 25 photographs (with given timing as during rest or push) patients with classify using classification. sent by email April 19, 2021 available online until July 5, 2021. Interobserver assessed Fleiss' Kappa test.A total 329 surgeons, fellows were an invitation email, whom 95 (29%) completed survey. Among respondents, 87% indicated that they Eighty-one percent found helpful 63% classified according followed guidelines accordingly. showed overall fair strength agreement, a (κ) 0.376 (95% CI 0.373-0.380). There moderate agreement grade I IV κ statistic 0.466 0.522, respectively. For grades II III, there lower (fair) 0.206 0.378, respectively.The disappointing demonstrates need more reliable, internationally accepted, HD. A new should enable uniformity treating comparing outcomes future trials prospective registries. protocol Delphi system currently being prepared led international research group.