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纤维内镜吞咽功能评估的组内和组间可靠性。

Inter- and intra-rater reliability in fibroptic endoscopic evaluation of swallowing.

机构信息

School of Dentistry, Nihon University, Tokyo, Japan.

出版信息

J Oral Rehabil. 2010 Dec;37(12):884-91. doi: 10.1111/j.1365-2842.2010.02116.x.

Abstract

Fibroptic endoscopic evaluation of swallowing (FEES) is a useful way for dentists to evaluate oropharyngeal dysfunction. However, no study has paid attention to inter- and intra-rater reliability of FEES evaluation about oropharyngeal dysfunction. The purpose of this study is to verify whether dentist who trained and experienced for evaluation of dysphagia could diagnose oropharyngeal function with FEES. Nine dentists independently evaluated FEES images of 10 cases four times each. At first, evaluators performed the first evaluation without consulting the evaluative criteria. Subsequently, evaluators independently re-evaluated at 1-week intervals for three consecutive weeks, consulting the evaluative criteria. And then, inter- and intra-rater reliability was calculated. Cohen's Kappa was used to assess reliability. The results found that overall inter-rater reliability was 0·35±0·04 (first evaluation), 0·45±0·05 (s), 0·44±0·05 (third) and 0·46±0·04 (fourth). Most of inter-rater reliability related to aspiration was moderate to high, but lower for categories that evaluated timing of swallowing and mastication. In contrast, intra-rater reliability was moderate to high for overall categories, at 0·53±0·04 (first vs. second evaluation), 0·55±0·04 (first vs. third), 0·53±0·04 (first vs. fourth), 0·55±0·03 (second vs. third), 0·60±0·03 (second vs. fourth) and 0·78±0·03 (third vs. fourth). FEES is reliable for experienced dentists to diagnose oropharyngeal function. Moreover, repeated evaluation with the aids of evaluative criteria is useful to improve the reliability of FEES.

摘要

纤维内镜吞咽功能检查(FEES)是牙医评估口咽功能的一种有用方法。然而,目前还没有研究关注经过培训和经验丰富的牙医使用 FEES 评估口咽功能的组内和组间可靠性。本研究旨在验证经过吞咽障碍评估培训和经验丰富的牙医是否可以使用 FEES 诊断口咽功能。9 名牙医独立评估了 10 例患者的 4 次 FEES 图像,每次评估 4 次。首先,评估者在不参考评估标准的情况下进行第一次评估。随后,评估者在连续三周内每周间隔 1 周,参考评估标准,分别进行三次独立的重新评估。然后,计算组内和组间可靠性。采用 Cohen's Kappa 评估可靠性。结果发现,总体组间可靠性为 0.35±0.04(第一次评估)、0.45±0.05(s)、0.44±0.05(第三次)和 0.46±0.04(第四次)。与误吸相关的大多数组间可靠性为中度到高度,但与评估吞咽和咀嚼时间的类别相关的可靠性较低。相比之下,整体类别的组内可靠性为中度到高度,0.53±0.04(第一次与第二次评估)、0.55±0.04(第一次与第三次)、0.53±0.04(第一次与第四次)、0.55±0.03(第二次与第三次)、0.60±0.03(第二次与第四次)和 0.78±0.03(第三次与第四次)。FEES 对经验丰富的牙医诊断口咽功能是可靠的。此外,使用评估标准进行重复评估有助于提高 FEES 的可靠性。

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