Validation of the German Version of the Yale Pharyngeal Residue Severity Rating Scale

Abstract

The aim of this study was to validate the German Version of the Yale Pharyngeal Residue Severity Rating Scale and to investigate the impact of rater experience and training. The English original scale was translated into German language using a forward-backward method. For the validation, 30 images of different pharyngeal residue amounts have been selected and assigned to the scales' severity levels by two experts. 28 raters rated the images in randomized order in two passes. To investigate the impact of experience and training, raters were grouped into subgroups. Statistical analysis was carried out using kappa statistics. The results demonstrate excellent residue ratings for construct validity, inter-rater reliability and intra-rater reliability regarding overall group and all subgroups (Kappa > 0.90). No significant differences were found between groups by experience and inconstant differences were found between groups by training. The German version of the Yale Pharyngeal Residue Severity Rating Scale is a valid, reliable instrument for scoring location and severity of pharyngeal residue in the context of flexible endoscopic evaluations of swallowing.

Reliability and Construct Validity of the Yale Pharyngeal Residue Severity Rating Scale: Performance on Videos and Effect of Bolus Consistency

“…These values are comparable to those of previous studies. Neubauer et al [ 11 ] reported a construct validity of 0.951 in the valleculae frames (the value in this study is 0.89) and of 0.908 in the piriform sinuses (in this study, 0.87), and Gerschke [ 17 ] found almost perfect Kappa values for both sites (k > 0.90). For intra-rater reliability Neubauer et al [ 11 ] reported Kappa values of 0.957 for vallecula (in this study 0.93) and 0.854 for pyriform sinus (in this study 0.84), German values were of 0.963 for valleculae and 0.944 for pyriform sinus [ 17 ].…”

“…Neubauer et al [ 11 ] reported a construct validity of 0.951 in the valleculae frames (the value in this study is 0.89) and of 0.908 in the piriform sinuses (in this study, 0.87), and Gerschke [ 17 ] found almost perfect Kappa values for both sites (k > 0.90). For intra-rater reliability Neubauer et al [ 11 ] reported Kappa values of 0.957 for vallecula (in this study 0.93) and 0.854 for pyriform sinus (in this study 0.84), German values were of 0.963 for valleculae and 0.944 for pyriform sinus [ 17 ]. Lastly, Neubauer et al [ 11 ] found inter-rater reliability values of 0.868 and 0.751 for valleculae and pyriform sinus (in this study, 0.85 and 0.82), German values were 0.928 and 0.938 for valleculae and pyriform sinus [ 17 ].…”

“…Two experts, a phoniatrician and a speech and language pathologist (SLP), with at least ten years of experience in dysphagia, independently assessed a total of 70 pairs of videos and frames by assigning to each of them a level of the YPRSRS. The judgment of two experts was used as the gold standard for the construct validity analysis, according to the procedure used in the YPRSRS validation in the German paper [ 17 ]. Only the frames and videos that had obtained a perfect agreement on the score from the experts were selected.…”

“…The authors consider the scale generalizable and applicable to all age groups thanks to the operational definitions, which refer to the residue and anatomical indices. To date, the YPRSRS has been validated in English [ 11 ], German [ 17 ], and Turkish [ 18 ]. The German and Turkish studies were based on FEES images from the original validation study, which displayed bolus residue of yellow pudding, white milk, or no residue.…”

Training for fiberoptic endoscopic evaluation of swallowing parameter analysis: a scoping review protocol

“…Severity classification scales have been developed and submitted to reliability analyses to classify the presence of food residues after swallowing in the pharyngeal regions [7][8][9][10][11] . The Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) 9 is one of the most used 12,13 . The Penetration-Aspiration Scale (PAS) 14 , with already determined reliability indices 6,15,16 , was developed for the parameter that investigates the risk of LP and/or LA, which is closely related to swallowing safety.…”