TY - JOUR
T1 - Introducing the HOPE (Hypospadias Objective Penile Evaluation)-score: A validation study of an objective scoring system for evaluating cosmetic appearance in hypospadias patients
AU - van der Toorn, Fred
AU - de Jong, Tom P. V. M.
AU - de Gier, Robert P. E.
AU - Callewaert, Piet R. H.
AU - van der Horst, Eric H. J. R.
AU - Steffens, Martijn G.
AU - Hoebeke, Piet
AU - Nijman, Rien J. M.
AU - Bush, Nicol C.
AU - Wolffenbuttel, Katja P.
AU - van den Heijkant, Marleen M. C.
AU - van Capelle, Jan-Willem
AU - Wildhagen, Mark
AU - Timman, Reinier
AU - Busschbach, Jan J. V.
PY - 2013/12
Y1 - 2013/12
N2 - Objective: To determine the reliability and internal validity of the Hypospadias Objective Penile Evaluation (HOPE)-score, a newly developed scoring system assessing the cosmetic outcome in hypospadias. Patients and methods: The HOPE scoring system incorporates all surgically-correctable items: position of meatus, shape of meatus, shape of glans, shape of penile skin and penile axis. Objectivity was established with standardized photographs, anonymously coded patients, independent assessment by a panel, standards for a "normal" penile appearance, reference pictures and assessment of the degree of abnormality. A panel of 13 pediatric urologists completed 2 questionnaires, each consisting of 45 series of photographs, at an interval of at least 1 week. The inter-observer reliability, intra-observer reliability and internal validity were analyzed. Results: The correlation coefficients for the HOPE-score were as follows: intra-observer reliability 0.817, inter-observer reliability 0.790, "non-parametric" internal validity 0.849 and "parametric" internal validity 0.842. These values reflect good reproducibility, sufficient agreement among observers and a valid measurement of differences and similarities in cosmetic appearance. Conclusions: The HOPE-score is the first scoring system that fulfills the criteria of a valid measurement tool: objectivity, reliability and validity. These favorable properties support its use as an objective outcome measure of the cosmetic result after hypospadias surgery.
AB - Objective: To determine the reliability and internal validity of the Hypospadias Objective Penile Evaluation (HOPE)-score, a newly developed scoring system assessing the cosmetic outcome in hypospadias. Patients and methods: The HOPE scoring system incorporates all surgically-correctable items: position of meatus, shape of meatus, shape of glans, shape of penile skin and penile axis. Objectivity was established with standardized photographs, anonymously coded patients, independent assessment by a panel, standards for a "normal" penile appearance, reference pictures and assessment of the degree of abnormality. A panel of 13 pediatric urologists completed 2 questionnaires, each consisting of 45 series of photographs, at an interval of at least 1 week. The inter-observer reliability, intra-observer reliability and internal validity were analyzed. Results: The correlation coefficients for the HOPE-score were as follows: intra-observer reliability 0.817, inter-observer reliability 0.790, "non-parametric" internal validity 0.849 and "parametric" internal validity 0.842. These values reflect good reproducibility, sufficient agreement among observers and a valid measurement of differences and similarities in cosmetic appearance. Conclusions: The HOPE-score is the first scoring system that fulfills the criteria of a valid measurement tool: objectivity, reliability and validity. These favorable properties support its use as an objective outcome measure of the cosmetic result after hypospadias surgery.
KW - Hypospadias
KW - Outcome assessment
KW - Scoring system
KW - Surgery
U2 - 10.1016/j.jpurol.2013.01.015
DO - 10.1016/j.jpurol.2013.01.015
M3 - Article
C2 - 23491983
SN - 1477-5131
VL - 9
SP - 1006
EP - 1016
JO - Journal of Pediatric Urology
JF - Journal of Pediatric Urology
IS - 6
ER -