Introducing the HOPE (Hypospadias Objective Penile Evaluation)-score: A validation study of an objective scoring system for evaluating cosmetic appearance in hypospadias patients

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• 作者：Fred van der Toorn ; Tom P.V.M. de Jong ; Robert P.E. de Gier ; Piet R.H. Callewaert ; Eric H.J.R. van der Horst ; Martijn G. Steffens ; Piet Hoebeke ; Rien J.M. Nijman ; Nicol C. Bush ; Katja P. Wolffenbuttel ; Marleen M.C. van den Heijkant ; Jan-Willem van Capelle ; Mark Wildhagen ; Reinier Timman ; Jan J.V. van Busschbach
• 关键词：Hypospadias ; Outcome assessment ; Scoring system ; Surgery
• 刊名：Journal of Pediatric Urology
• 出版年：December, 2013
• 年：2013
• 卷：9
• 期：6
• 页码：1006-1016
• 全文大小：3054 K

文摘

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 鈥渘ormal鈥?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, 鈥渘on-parametric鈥?internal validity 0.849 and 鈥減arametric鈥?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.