Journal article
Interrater Reliability of Objective and Subjective Measures of Urinary Tract Dilation by Pediatric Urologists: A Multicenter Analysis
Journal of pediatric urology, Vol.21(6), pp.1764-1770
12/2025
DOI: 10.1016/j.jpurol.2025.06.025
PMID: 40744764
Abstract
The ideal parameters to predict significant antenatal hydronephrosis remain controversial. Given the subjectivity of the Society of Fetal Urology (SFU) and Urinary Tract Dilation (UTD) grading systems, more objective measurements like medullary pyramidal thickness (PT) and parenchymal thickness (ParT) may be useful.
We sought to assess the interrater reliability of objective measures of hydronephrosis and the UTD grading system among pediatric urologists at multiple institutions through the Societies of Pediatric Urology (SPU) Hydronephrosis Task Force Registry.
Fifteen renal sonograms of infants from a single center were chosen from patients enrolled in the registry's prospective database. Images were shared confidentially with pediatric urologists at participating institutions. Reviewers were taught standardized measurement techniques. Eight reviewers from five institutions analyzed each study and recorded anterior posterior renal pelvis diameter (APD), PT, ParT, and UTD grade.
Interrater reliability was analyzed using Intraclass Correlation Coefficient (ICC) with 95% CI, one-way random effects, consistency model for continuous variables and percent agreement for binary variables. Light’s kappa with 95% CI was calculated for reliability of UTD grade.
Reviewers collected data on fifteen renal sonograms for a total of 30 units. APD had excellent reliability, PT moderate to good reliability, and ParT poor to moderate reliability. One reviewer was found to be an outlier with respect to ParT measurements. When assessed as a binary variable (>3mm vs. <3mm) the percent agreement between reviewers for PT was 70%. UTD grade was considered to have weak to moderate reliability with a Light's Kappa of 0.43. The most common discrepancy between graders was the distinction between UTD P2 and P3.
APD demonstrated the highest interrater reliability among objective assessments of antenatal hydronephrosis.PT had moderate to good reliability and was more reliable than ParT. This analysis highlights the need for incorporation of more reliable methods to characterize UTD.
Details
- Title: Subtitle
- Interrater Reliability of Objective and Subjective Measures of Urinary Tract Dilation by Pediatric Urologists: A Multicenter Analysis
- Creators
- Gina M. Lockwood - Department of Urology, University of Iowa, Iowa City, IA, USAAlexander J. Leach - University of IowaJude Shelton - University of IowaKnute D. Carter - University of IowaJacob Hansen - University of IowaAngelena Edwards - University of IowaDouglas W. Storm - University of IowaRebecca S. Zee - Virginia Commonwealth UniversityKristin Ebert - University of Wisconsin School of Medicine and Public HealthLouis Wojcik - Loma Linda UniversityShannon T. Cannon - University of Wisconsin School of Medicine and Public HealthJoshua D. Chamberlin - Loma Linda UniversityKunj Sheth - Stanford MedicineJanelle Fox - Children's Hospital of The King's DaughtersLuis H. Braga - McMaster UniversityValre Welch - Virginia Commonwealth UniversityAntoine E. Khoury - Children's Hospital of Orange CountyNora G. Kern - University of VirginiaCarol Davis-Dao - Children's Hospital of Orange CountyAnne G. Dudley - Connecticut Children's Medical CenterElias Wehbi - Children's Hospital of Orange CountySarah Williamson - Children's Hospital of The King's DaughtersCD Anthony Herndon - Virginia Commonwealth UniversityChristopher S. Cooper - Department of Urology, University of Iowa, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Journal of pediatric urology, Vol.21(6), pp.1764-1770
- DOI
- 10.1016/j.jpurol.2025.06.025
- PMID
- 40744764
- NLM abbreviation
- J Pediatr Urol
- ISSN
- 1477-5131
- Publisher
- Elsevier Ltd
- Language
- English
- Electronic publication date
- 06/2025
- Date published
- 12/2025
- Academic Unit
- Stead Family Department of Pediatrics; Biostatistics; Surgery; Urology; Medicine Administration
- Record Identifier
- 9984843596602771
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