Validation of the Clavien-Madadi Classification for Unexpected Events in Pediatric Surgery: A Collaborative ERNICA Project

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dc.authoridAYDIN, Emrah/0000-0001-7776-9684
dc.authoridMutanen, Annika/0000-0003-1575-5601
dc.authoridWiesner, Soren/0000-0002-3989-8650
dc.authoridEaton, Simon/0000-0003-0892-9204
dc.contributor.authorMadadi-Sanjani, Omid
dc.contributor.authorKuebler, Joachim F.
dc.contributor.authorBrendel, Julia
dc.contributor.authorCostanzo, Sara
dc.contributor.authorGranstroem, Anna L.
dc.contributor.authorAydin, Emrah
dc.contributor.authorLoukogeorgakis, Stavros
dc.date.accessioned2024-10-29T17:58:27Z
dc.date.available2024-10-29T17:58:27Z
dc.date.issued2024
dc.departmentTekirdağ Namık Kemal Üniversitesi
dc.description.abstractBackground: The Clavien-Madadi classification is a novel instrument for the assessment and grading of unexpected events in pediatric surgery, based on the Clavien-Dindo classification. The system has been adjusted to better fit the pediatric population in a prospective single-center study. There is a need now to validate the Clavien-Madadi classification within an international expert network. Methods: A pediatric surgical working group created 19 case scenarios with unexpected events in a multi-staged process. Those were circulated within the European Reference Network of Inherited and Congenital Anomalies (ERNICA) and surgeons were instructed to rate the scenarios according to the Clavien-Madadi vs. Clavien-Dindo classification. Results: 59 surgeons from 12 European countries completed the questionnaire. Based on ratings of the case scenarios, the Clavien-Madadi classification showed significantly superior agreement rates of the respondents (85.9% vs 76.2%; p < 0.05) and was less frequently considered inaccurate for rating the pediatric population compared to Clavien-Dindo (2.1% vs 11.1%; p = 0.05). Fleiss' kappa analysis showed slightly higher strength of agreement using the Clavien-Madadi classification (0.74 vs 0.69). Additionally, intraclass correlation coefficient was slightly higher for the Clavien-Madadi compared to the Clavien-Dindo classification (ICCjust 0.93 vs 0.89; ICCunjust 0.93 vs 0.89). More pediatric surgeons preferred the Clavien-Madadi classification for the case scenarios (43.0% vs 11.8%; p = 0.002) and advantages of the Clavien-Madadi were confirmed by 81.4% of the surgeons. Conclusion: The Clavien-Madadi classification is an accurate and reliable instrument for the grading of unexpected events in pediatric surgery. We therefore recommend its application in clinical and academic pediatric surgical practice. (c) 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
dc.description.sponsorshipThis work was financed by the general budgets of the de-partments involved.
dc.identifier.doi10.1016/j.jpedsurg.2024.03.022
dc.identifier.endpage1679
dc.identifier.issn0022-3468
dc.identifier.issn1531-5037
dc.identifier.issue9en_US
dc.identifier.pmid38582705
dc.identifier.scopus2-s2.0-85189474693
dc.identifier.scopusqualityQ1
dc.identifier.startpage1672
dc.identifier.urihttps://doi.org/10.1016/j.jpedsurg.2024.03.022
dc.identifier.urihttps://hdl.handle.net/20.500.11776/14331
dc.identifier.volume59
dc.identifier.wosWOS:001292562200001
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherW B Saunders Co-Elsevier Inc
dc.relation.ispartofJournal of Pediatric Surgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectComplications
dc.subjectUnexpected events
dc.subjectAdverse events
dc.subjectClavien-Dindo
dc.subjectClavien-Madadi
dc.titleValidation of the Clavien-Madadi Classification for Unexpected Events in Pediatric Surgery: A Collaborative ERNICA Project
dc.typeArticle

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