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

Willem M.P. Heijboer*, Adam Weir, Zarko Vuckovic, Karl Fullam, Johannes L. Tol, Eamonn Delahunt, Andreas Serner

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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.

Original languageEnglish
Pages (from-to)189-196
Number of pages8
JournalScandinavian Journal of Medicine and Science in Sports
Volume33
Issue number2
DOIs
Publication statusE-pub ahead of print - 18 Oct 2022

Bibliographical note

Funding Information:
This study was internally funded by Aspetar Orthopaedic and Sports Medicine Hospital.

Publisher Copyright:
© 2022 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.

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