Kv. Kuhlemeier et al., INTRARATER AND INTERRATER VARIATION IN THE EVALUATION OF VIDEOFLUOROGRAPHIC SWALLOWING STUDIES, Dysphagia, 13(3), 1998, pp. 142-147
The objective of this study was to determine the inter-and intrarater
reliability in evaluating videofluoroscopic swallowing studies (VFSS).
Participants included 4 physicians (3 physiatrists and 1 internist) a
nd 5 speech-language pathologists with at least 5 years experience in
evaluating VFSS. The main outcomes of the study were reliability ratio
s of positive and negative tests in inter-and intrarater evaluations.
Raters independently rated each of 20 VFSS on two separate occasions.
Traits evaluated included oral stage impairment, aspiration, pharyngea
l retention, and several functional components: timing of swallow onse
t, adequacy of velopharyngeal apposition, laryngeal elevation, epiglot
tic tilt, pharyngeal contraction, and pharyngoesophageal (PE) segment
opening. Reliability varied widely depending on food type and the trai
t under evaluation. Inter-and intrarater reliability ratios did not di
ffer widely. Reliability ratios values typically were highest (greater
than 90%) for aspiration, especially with solid food, and lowest for
the functional components. It was concluded that inter-and intrarater
reliability in VFSS are adequate for evaluating oral stage, laryngeal
penetration, and aspiration and pharyngeal retention, but questionable
for functional components.