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Evaluation of the Accuracy of the POGO Score
A classification method describing the larynx appearance during laryngoscopy accepted by all anesthetists has not been defined yet. In one study, it was shown that anesthetists mis classed the glottis image by 50%. The most commonly used classification method is the Cormack Lehane (CL) classification. This classification classifies the larynx appearance during direct laryngoscopy form 1 to 4. The modified CL classification is criticized as it does not predict difficult intubation and especially grade 2 is operator dependent and partial view is not well defined. The numerical expression of the percentage of the glottic aperture (POGO = percentile of glottic opening) is another score. In this score, A POGO score of 100% accounts for full visualization of the larynx starting from anterior commissure to the posterior cartilage, while 0% indicated a complete absence of glottic opening.
The use of a standard and effective classification method will facilitate and accelerate communication between anesthetists in difficult life-threatening situations such as difficult airway / difficult intubation / difficult ventilation and contribute to patient safety. The use of common terminology can also facilitate the evaluation of the performance of intubation tools.
The aim of this study was to evaluate the accuracy and intra and inter rater reliability of the POGO score.
| Condition or disease | Intervention/treatment |
|---|---|
| Intubation | Device: Videolaryngoscopy |
Anesthesiologist will be asked to score still images of laryngeal views, which will be obtained from patients requiring intubation for general anesthesia, after obtaining written informed consent.
The images of the larynx will be captured first with the Macintosh blade and thereafter with the D blade. A group of independent anesthesiologist will score these images with the Cormack Lehane and POGO scores. The set of images will be prepared from patients with both difficult and normal airway anatomy. Some images in the series will be repeated to assess intra rater variability.
The anesthesiologist will be asked to rate 20 images both with the CL and POGO scores.
The experience of the raters in airway management, their experience with videolaryngoscopy and scoring systems used currently when documenting videolaryngoscopy and demographic data will be also obtained.
The POGO scores of the participants and investigators will be compared.
The outcome of interest is the correct POGO score rate of the participants.
| Study Type : | Observational |
| Actual Enrollment : | 40 participants |
| Observational Model: | Other |
| Time Perspective: | Prospective |
| Official Title: | Evaluation of the Accuracy and the Intra and Inter Rater Reliability of the POGO Score |
| Actual Study Start Date : | May 30, 2019 |
| Actual Primary Completion Date : | June 25, 2019 |
| Actual Study Completion Date : | June 25, 2019 |
- Percentile of glottic opening [ Time Frame: 2 minutes after induction of anesthesia ]A percentile of glottic opening score of 100% accounts for full visualization of the larynx starting from anterior commissure to the posterior cartilage, while 0% indicated a complete absence of glottic opening.
| Tracking Information | |||||
|---|---|---|---|---|---|
| First Submitted Date | May 21, 2019 | ||||
| First Posted Date | May 23, 2019 | ||||
| Last Update Posted Date | December 27, 2019 | ||||
| Actual Study Start Date | May 30, 2019 | ||||
| Actual Primary Completion Date | June 25, 2019 (Final data collection date for primary outcome measure) | ||||
| Current Primary Outcome Measures |
Percentile of glottic opening [ Time Frame: 2 minutes after induction of anesthesia ] A percentile of glottic opening score of 100% accounts for full visualization of the larynx starting from anterior commissure to the posterior cartilage, while 0% indicated a complete absence of glottic opening.
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| Original Primary Outcome Measures | Same as current | ||||
| Change History | |||||
| Current Secondary Outcome Measures | Not Provided | ||||
| Original Secondary Outcome Measures | Not Provided | ||||
| Current Other Pre-specified Outcome Measures | Not Provided | ||||
| Original Other Pre-specified Outcome Measures | Not Provided | ||||
| Descriptive Information | |||||
| Brief Title | Evaluation of the Accuracy of the POGO Score | ||||
| Official Title | Evaluation of the Accuracy and the Intra and Inter Rater Reliability of the POGO Score | ||||
| Brief Summary |
A classification method describing the larynx appearance during laryngoscopy accepted by all anesthetists has not been defined yet. In one study, it was shown that anesthetists mis classed the glottis image by 50%. The most commonly used classification method is the Cormack Lehane (CL) classification. This classification classifies the larynx appearance during direct laryngoscopy form 1 to 4. The modified CL classification is criticized as it does not predict difficult intubation and especially grade 2 is operator dependent and partial view is not well defined. The numerical expression of the percentage of the glottic aperture (POGO = percentile of glottic opening) is another score. In this score, A POGO score of 100% accounts for full visualization of the larynx starting from anterior commissure to the posterior cartilage, while 0% indicated a complete absence of glottic opening. The use of a standard and effective classification method will facilitate and accelerate communication between anesthetists in difficult life-threatening situations such as difficult airway / difficult intubation / difficult ventilation and contribute to patient safety. The use of common terminology can also facilitate the evaluation of the performance of intubation tools. The aim of this study was to evaluate the accuracy and intra and inter rater reliability of the POGO score. |
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| Detailed Description |
Anesthesiologist will be asked to score still images of laryngeal views, which will be obtained from patients requiring intubation for general anesthesia, after obtaining written informed consent. The images of the larynx will be captured first with the Macintosh blade and thereafter with the D blade. A group of independent anesthesiologist will score these images with the Cormack Lehane and POGO scores. The set of images will be prepared from patients with both difficult and normal airway anatomy. Some images in the series will be repeated to assess intra rater variability. The anesthesiologist will be asked to rate 20 images both with the CL and POGO scores. The experience of the raters in airway management, their experience with videolaryngoscopy and scoring systems used currently when documenting videolaryngoscopy and demographic data will be also obtained. The POGO scores of the participants and investigators will be compared. The outcome of interest is the correct POGO score rate of the participants. |
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| Study Type | Observational | ||||
| Study Design | Observational Model: Other Time Perspective: Prospective |
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| Target Follow-Up Duration | Not Provided | ||||
| Biospecimen | Not Provided | ||||
| Sampling Method | Non-Probability Sample | ||||
| Study Population | Patients undergoing surgery and those who are intubated | ||||
| Condition | Intubation | ||||
| Intervention | Device: Videolaryngoscopy
Patient will be intubated by using videolaryngoscope
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| Study Groups/Cohorts | Not Provided | ||||
| Publications * |
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* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline. |
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| Recruitment Information | |||||
| Recruitment Status | Completed | ||||
| Actual Enrollment |
40 | ||||
| Original Estimated Enrollment |
20 | ||||
| Actual Study Completion Date | June 25, 2019 | ||||
| Actual Primary Completion Date | June 25, 2019 (Final data collection date for primary outcome measure) | ||||
| Eligibility Criteria |
Inclusion Criteria:
Exclusion Criteria:
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| Sex/Gender |
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| Ages | 18 Years to 80 Years (Adult, Older Adult) | ||||
| Accepts Healthy Volunteers | No | ||||
| Contacts | Contact information is only displayed when the study is recruiting subjects | ||||
| Listed Location Countries | Turkey | ||||
| Removed Location Countries | |||||
| Administrative Information | |||||
| NCT Number | NCT03960567 | ||||
| Other Study ID Numbers | POGO | ||||
| Has Data Monitoring Committee | No | ||||
| U.S. FDA-regulated Product |
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| IPD Sharing Statement |
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| Responsible Party | DILEK YAZICIOGLU, Diskapi Teaching and Research Hospital | ||||
| Study Sponsor | Diskapi Teaching and Research Hospital | ||||
| Collaborators | Not Provided | ||||
| Investigators |
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| PRS Account | Diskapi Teaching and Research Hospital | ||||
| Verification Date | May 2019 | ||||