Inter- and intrajudge reliability of a clinical examination of swallowing in adults

This study investigates inter- and intrajudge reliability of a clinical exa mination of swallowing in adults. Several investigations have sought correl ations between clinical indicators of dysphagia and the actual presence of dysphagia as determined by videofluoroscopy. Whereas some investigations ha ve reported interjudge reliability for the videofluoroscopic measures emplo yed, none have reported reliability for clinical measures. Without establis hed reliability for rating clinical measures, conclusions drawn regarding t he utility of a measure for detecting aspiration can be called into questio n. Results of the present study indicate that fewer than 50% of the measure s clinicians typically employ are rated with sufficient inter- and intrajud ge reliability. Measures of vocal quality and oral motor function were rate d more reliably than were history measures or measures taken during trial s wallows. There is a need to define more clearly the measures employed in cl inical examinations and to be consistent in reporting reliability for clini cal measures of swallowing function in future research.