{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T23:25:46Z","timestamp":1775604346927,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T00:00:00Z","timestamp":1463443200000},"content-version":"vor","delay-in-days":3393,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2007,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To design a grading scale for vocal fold nodules in pediatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Setting<\/jats:title><jats:p>We conducted a prospective study in which a grading scale for vocal nodule size and contour based on static fiberoptic images of pediatric larynges was developed to achieve the scale presented here.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010eight health care professionals each rated 28 images of pediatric vocal fold nodules. The intraclass correlation for nodule size was strong (0.77; 95% confidence interval, 0.67\u20130.87). The \u03ba statistic for nodule contour was mild (0.35; 95% confidence interval, 0.33\u20130.37). Agreement between experienced and other raters found no significant difference for the nodule size or contour grade of a given image.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A grading scale for pediatric vocal fold nodules is presented. Interrater reliability for nodule size is high and can be reliably used by health care professionals with varying levels of experience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>A validated grading scale facilitates objective analysis of outcomes when studying and following patients with vocal nodules.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.otohns.2006.11.003","type":"journal-article","created":{"date-parts":[[2007,2,3]],"date-time":"2007-02-03T02:46:06Z","timestamp":1170470766000},"page":"193-197","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["A grading scale for pediatric vocal fold nodules"],"prefix":"10.1002","volume":"136","author":[{"given":"Rahul K.","family":"Shah","sequence":"first","affiliation":[{"name":"Division of Otolaryngology Children's National Medical Center Washington, D.C."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry A.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Clinical Research Program Children's Hospital Boston Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger C.","family":"Nuss","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Children's Hospital Boston Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,5,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra035148"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949510400103"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(02)00102-9"},{"key":"e_1_2_6_5_1","unstructured":"NussRC WoodnorthGH GlynnA.Spectrum of voice disorders in children.Podium presentation at Annual Meeting of The American Society of Pediatric Otolaryngology Nashville TN May 4\u20135 2003"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2005.01.029"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529786"},{"key":"e_1_2_6_8_1","volume-title":"SAS system for mixed models.","author":"Littell RC","year":"1996"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1180"},{"key":"e_1_2_6_10_1","first-page":"212","volume-title":"Statistical methods for rates and proportions","author":"Fleiss JL","year":"1981"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2003.11.005"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2006.11.003","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.otohns.2006.11.003","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2006.11.003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T08:55:33Z","timestamp":1760950533000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.otohns.2006.11.003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,2]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2007,2]]}},"alternative-id":["10.1016\/j.otohns.2006.11.003"],"URL":"https:\/\/doi.org\/10.1016\/j.otohns.2006.11.003","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,2]]},"assertion":[{"value":"2016-05-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}