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. 2023 Feb;33(2):189-196.
doi: 10.1111/sms.14248. Epub 2022 Oct 29.

Inter-examiner reliability of the Doha agreement meeting classification system of groin pain in male athletes

Willem M P Heijboer  1   2   3   4 , Adam Weir  1   5   6 , Zarko Vuckovic  1 , Karl Fullam  7 , Johannes L Tol  1   2   3 , Eamonn Delahunt  8   9 , Andreas Serner  1   10
Affiliations

Inter-examiner reliability of the Doha agreement meeting classification system of groin pain in male athletes

Willem M P Heijboer et al. Scand J Med Sci Sports. 2023 Feb.

Abstract

The Doha agreement classification is used to classify groin pain in athletes. We evaluated the inter-examiner reliability of this classification system. We prospectively recruited 48 male athletes (66 symptomatic sides) with groin pain between 10-2017 and 03-2020 at a sports medicine hospital in Qatar. Two examiners (23 and 10 years of clinical experience) performed history taking, and a standardized clinical examination blinded to each other's findings. Examiners classified groin pain using the Doha agreement terminology (adductor-, inguinal-, iliopsoas-, pubic-, hip-related groin pain, or other causes of groin pain). Multiple entities were ranked in order of perceived clinical importance. Each side was classified separately for bilateral groin pain. Inter-examiner reliability was calculated using Cohen's Kappa statistic (κ). Inter-examiner reliability was slight to moderate for adductor- (κ = 0.40), inguinal- (κ = 0.44), iliopsoas- (κ = 0.57), and pubic-related groin pain (κ = 0.12), substantial for hip-related groin pain (κ = 0.62), and slight for "other causes of groin pain" (κ = 0.13). Ranking entities in order of perceived clinical importance improved inter-examiner reliability for adductor-, inguinal-, and iliopsoas-related groin pain (κ = 0.52-0.65), but not for pubic (κ = 0.12), hip (κ = 0.51), and "other causes of groin pain" (κ = 0.03). For participants with unilateral groin pain classified with a single entity (n = 7), there was 100% agreement between the two examiners. Inter-examiner reliability of the Doha agreement meeting classification system varied from slight to substantial, depending on the clinical entity. Agreement between examiners was perfect when athletes were classified with a single clinical entity of groin pain, but lower when athletes were classified with multiple clinical entities.

Keywords: clinical assessment; diagnosis; groin pain; hip/pelvis/thigh.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Classification of clinical entities based on symptoms and examination findings. Figure reproduced with permission from Weir et al.
See this image and copyright information in PMC

References

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