Sie Kathleen C Y, Starr Jacqueline R, Bloom David C, Cunningham Michael, de Serres Lianne M, Drake Amelia F, Elluru Ravindhra G, Haddad Joseph, Hartnick Christopher, Macarthur Carol, Milczuk Henry A, Muntz Harlan R, Perkins Jonathan A, Senders Craig, Smith Marshall E, Tollefson Travis, Willging Jay Paul, Zdanski Carlton J
Division of Pediatric Otolaryngology, Childhood Communication Center, Children's Hospital and Regional Medical Center, PO Box 5371/6E-1, Seattle, WA 98105-0371, USA.
Arch Otolaryngol Head Neck Surg. 2008 Jul;134(7):757-63. doi: 10.1001/archotol.134.7.757.
To explore interrater and intrarater reliability (R (inter) and R (intra), respectively) of a standardized scale applied to nasoendoscopic assessment of velopharyngeal (VP) function, across multiple centers.
Multicenter blinded R (inter) and R (intra) study.
Eight academic tertiary care centers.
Sixteen otolaryngologists from 8 centers.
Raters estimated lateral pharyngeal and palatal movement on nasoendoscopic tapes from 50 different patients. Raters were asked to (1) estimate gap size during phonation and (2) note the presence of the Passavant ridge, a midline palatal notch on the nasal surface of the soft palate, and aberrant pulsations. Primary outcome measures were R (inter) and R (intra) coefficients for estimated gap size, lateral wall, and palatal movement; kappa coefficients for the Passavant ridge, a midline palatal notch on the nasal soft palate, and aberrant pulsations were also calculated.
The R (inter) coefficients were 0.63 for estimated gap size, 0.41 for lateral wall movement, and 0.43 for palate movement; corresponding R (intra) coefficients were 0.86, 0.79, and 0.83, respectively. Interrater kappa values for qualitative features were 0.10 for the Passavant ridge; 0.48 for a notch on the nasal surface of the soft palate, 0.56 for aberrant pulsations, and 0.39 for estimation of gap size.
In these data, there was good R (intra) and fair R (inter) when using the Golding-Kushner scale for rating VP function based on nasoendoscopy. Estimates of VP gap size demonstrate higher reliability coefficients than total lateral wall, mean palate estimates, and categorical estimate of gap size. The reliability of rating qualitative characteristics (ie, the presence of the Passavant ridge, aberrant pulsations, and notch on the nasal surface of the soft palate) is variable.
在多个中心探讨应用于鼻咽部（VP）功能鼻内镜评估的标准化量表的评分者间信度和评分者内信度（分别为R(inter)和R(intra)）。
多中心盲法R(inter)和R(intra)研究。
8家学术性三级医疗中心。
来自8个中心的16名耳鼻喉科医生。
评分者根据50例不同患者的鼻内镜录像估计咽侧壁和腭部的运动情况。要求评分者（1）估计发声时的间隙大小，（2）记录帕萨凡特嵴（软腭鼻面的中线腭切迹）的存在情况以及异常搏动。主要观察指标为估计间隙大小、侧壁和腭部运动的R(inter)和R(intra)系数；还计算了帕萨凡特嵴、软腭鼻面的中线腭切迹以及异常搏动的kappa系数。
估计间隙大小的R(inter)系数为0.63，侧壁运动的为0.41，腭部运动的为0.43；相应的R(intra)系数分别为0.86、0.79和0.83。定性特征的评分者间kappa值，帕萨凡特嵴为0.10；软腭鼻面切迹为0.48，异常搏动为0.56，间隙大小估计为0.39。
在这些数据中，使用戈尔丁 - 库什纳量表基于鼻内镜对VP功能进行评分时，R(intra)良好，R(inter)尚可。VP间隙大小的估计显示出比咽侧壁整体、腭部平均估计以及间隙大小分类估计更高的信度系数。对定性特征（即帕萨凡特嵴、异常搏动和软腭鼻面切迹的存在）评分的信度存在差异。
