Inter- and Intrajudge Reliability for Videofluoroscopic Swallowing Evaluation Measures

Abstract

Interjudge reliability for videofluoroscopic (VFS) swallowing evaluations has been investigated, and results have, for the most part, indicated that reliability is poor. While previous studies are well-designed investigations of interjudge reliability, few reports of intrajudge reliability are available for VFS measures derived from frame-by-frame analysis that clinicians typically employ. The purpose of this study was to examine the inter- and intrajudge reliability of VFS examination measures commonly used to assess swallowing functions. No training to criteria occurred. VFS examinations were conducted on 20 patients who had suffered a stroke within six weeks and had no structural abnormalities or tracheostomies. Three clinical judges served as subjects and rated the VFS examinations from videotape using frame-by-frame analysis. A clinician's repeated review of measures employed in the 20 examinations indicated high intrajudge reliability for a number of measures, suggesting that an experienced clinician may employ consistent standards for rating certain VFS measures across patients and time. These standards appear to vary among clinicians and yield unacceptable interjudge reliability. The need to train clinicians to criteria to improve interjudge reliability is discussed.

Early Assessments of Dysphagia and Aspiration Risk in Acute Stroke Patients

“…McCullough et al 35 examined common VF measures and found that statistics for interjudge reliability ranged from ϭ0 to 0.478; percentage agreement (calculated when was not possible) reached 92% on some variables. Intrajudge reliability has been greater in some studies but not in others.…”

Análise videofluoroscópica bidimensional perceptual da fase faríngea da deglutição em indivíduos acima de 50 anos

“…A reliable interpretation of images must be performed regardless of whether the images are from the same subject at different times or from a group of subjects at the same time for the VF to be regarded as a valid and reliable instrument of evaluation. VF studies show low levels of agreement for several parameters 16,25,29 . The parameter with the highest agreement regards the presence or absence of aspiration 10 , especially when compared with the assessment of severity of the vallecular residue 16,19,21,25 .…”

“…VF studies show low levels of agreement for several parameters 16,25,29 . The parameter with the highest agreement regards the presence or absence of aspiration 10 , especially when compared with the assessment of severity of the vallecular residue 16,19,21,25 . In the present study, the methodology used for assessing the percentage of vallecular residue was effective and demonstrated high/satisfactory reproducibility.…”

“…Because of its objectivity and specificity, the examination enables the analysis of other aspects of swallowing such as motility disorders of the oral and pharyngeal cavities, the presence of residue in the oral and pharyngeal cavities, the percentage of food residue accumulated along the digestive tract, and other esophageal aspects 15 . To assist in standardizing VF, some variables, including a definition of terms, criteria of event observations, analysis method, reproducibility of measurements, and evaluator expertise, deserve particular attention so that VF can be validated 10,12,16,29 . The aim of the current study is to propose and assess the reproducibility of a protocol for the two-dimensional perceptual videofluoroscopic analysis of swallowing in a population of healthy adults.…”

Disfagia orofaríngea em pacientes submetidos à intubação orotraqueal prolongada em UTIs

“…A confiabilidade 42,43 e validade da ausculta cervical, quando comparadas aos estudos que utilizam a VDF 44,45,46 , variam muito entre os estudos. Contudo, cabe ressaltar que a VDF também apresenta baixa confiabilidade para julgamentos intra e inter juízes 47,48,49,50 . 8,17 .…”