Abstract
This study aims to analyze inter-judge reliability by measuring a few temporal parameters of swallowing using a specific software. Six databases that include the results of reliability tests performed in prior studies by the present research group were employed. The datasets were obtained using the same measurement method and include data obtained based on puree (level 3) consistency and liquid (level 0) consistency according to the International Dysphagia Diet Standardization Initiative. In this study, the reliabilities corresponding to the total oral transit time (TOTT), initiation of the pharyngeal response time (PRT), and the pharyngeal transit time (PTT) were measured using the same software; the evaluations performed by a single rater for all datasets were used as the benchmark, and evaluations performed by new raters for each dataset were also included. The intra-class correlation coefficient (ICC) with a 95% confidence interval was employed. A total of 244 videofluoroscopic swallowing study images were analyzed. In all analyses, the ICCs were >0,75 and showed excellent agreement between the senior and junior raters. The TOTT for level 3 showed ICCs from 0.936 to 1.000 and that for level 0 showed ICCs from 0.997 to 1.000. Further, the PRT showed ICCs from 0.916 to 1.000 for level 3 and from 0.978 to 1.000 for level 0. The PTT showed ICCs from 0.848 to 1.000 for level 3 and from 0.984 to 1.000 for level 0. The reliabilities obtained using this specific software for the TOTT, PRT, and PTT showed excellent agreement.
Highlights
The interrater reliability in videofluoroscopic swallowing studies (VFSS) has been investigated to decrease the variability of findings related to swallowing, including the detection and interpretation of posterior oral spillage, penetration, aspiration, and the use of protocols and scales[1,2]
The results showed that the interpretation of videofluoroscopy results will continue to entail an extensive interrater variability until a greater number of specific diagnostic variables are systematically evaluated
Rater 1 and 3 evaluated the images obtained via studies 5 and 6, with 30 swallows images corresponding to each study
Summary
The interrater reliability in videofluoroscopic swallowing studies (VFSS) has been investigated to decrease the variability of findings related to swallowing, including the detection and interpretation of posterior oral spillage, penetration, aspiration, and the use of protocols and scales[1,2]. One study involving qualitative parameters aimed to determine whether directed search or free search can provide a substantially reliable interpretation of VFSS results. The interrater reliability results obtained using a free search appear promising, further research is needed to determine the manner in which the search method impacts detection, decision making, and accuracy with regard to VFSS measures[3]. VFSS serve as a crucial method to obtain knowledge regarding swallowing disorders In this regard, one study assessed the interrater reliability of videofluoroscopy for swallowing evaluation based on qualitative and quantitative parameters. Findings regarding aspiration are well defined, and such findings are diagnosed with high interobserver agreement[4]
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