Inter-rater Reliability of Videofluoroscopic Dysphagia Scale

Abstract

ObjectiveTo investigate the inter-rater agreement using the Videofluoroscopic Dysphagia Scale (VDS).MethodThe present study was designed as a multicenter, single-blind trial. A Videofluoroscopic Swallowing Study (VFSS) was performed using the protocol described by J.A Logemann. Thick-fluid, pureed food, mechanically altered food, regularly textured food, and thin-fluid boluses were sequentially swallowed. Each participant received a 3 ml bolus followed by a 5 ml bolus of each food material, in the order mentioned above. All study procedures were video recorded. Discs containing these video recordings in random order were distributed to interpreters who were blinded to the participant information. The video recordings were evaluated using a standardized VDS sheet and the inter-rater reliability was calculated.ResultsIn total, 100 patients participated in this study and 10 interpreters analyzed the findings. Inter-rater reliability was fair in terms of lip closure (κ: 0.325), oral transit time (0.253), delayed triggering of pharyngeal swallowing (0.300), vallecular residue (0.275), laryngeal elevation (0.345), pyriform sinus residue (0.310), coating of the pharyngeal wall (0.310), and aspiration (0.393). However, other parameters of the oral phase were lower than those of the pharyngeal phase (0.06-0.153). Moreover, the summation of VDS reliability (intraclass correlation coefficient: 0.556) showed moderate agreement.ConclusionVDS shows a moderate rate of agreement for evaluating the swallowing function. However, many of the parameters demonstrated a lower rate of agreement, particularly the oral phase parameters.

Characteristics of Patients With Aneurysmal Subarachnoid Hemorrhage and Risk Factors Related to Dysphagia

“…The VDS items reflect oral (lip closure, bolus formation, mastication, apraxia, premature bolus loss, oral transit time) and pharyngeal (pharyngeal triggering, vallecular and pyriform sinus residues, laryngeal elevation, epiglottic closure, pharyngeal coating, pharyngeal transit time, aspiration) functions that can be observed by the VFSS [11]. Severity of swallowing apraxia was categorized for different stages according to Daniels’ criteria [12]: normal (when instructed to swallow, the subject has no difficulty initiating and organizing lingual movements for bolus propulsion), mild (there is a slight delay in initiation and/or has oral transfer discoordination for bolus propulsion when instructed to swallow), moderate (initiation is markedly delayed and/or oral transfer discoordination for bolus propulsion exists) and severe (the subject cannot initiate and organize lingual movements).…”

Characteristics of Early Oropharyngeal Dysphagia in Patients with Multiple System Atrophy

“…The VDS, which was developed as an objective predictor of the prognosis of dysphagia after stroke [12], can be used for evaluating the quality of swallowing function in various etiologies [13]. It consists of 14 items with weighted values (a sum of 100 points, a higher score means more severe swallowing dysfunction), which evaluate oral and pharyngeal functions that can be observed by the VFSS.…”

Dysphagia in head and neck cancer: A review

“…Several scales have been developed to objectify the interpretation of VFSS. Reference [7] evaluated the inter-rater reliability of Videofluoroscopic Dsyphagia Scale (VDS). The scale consists of 14 items each of which can be classified as a measure of oral, pharyngeal, or esophageal function.…”

“…The scale consists of 14 items each of which can be classified as a measure of oral, pharyngeal, or esophageal function. Reference [7] found low reliability of all oral phase parameters. Pharyngeal and esophageal parameters demonstrated respectively higher inter-rater reliability, however total score reliability according to intra-class correlation coefficient was only 0.556.…”