Suppr超能文献

合并评分(P 评分):吞咽困难严重程度内镜评估中的评分者间和评分者内信度

The Pooling-score (P-score): inter- and intra-rater reliability in endoscopic assessment of the severity of dysphagia.

作者信息

Farneti D, Fattori B, Nacci A, Mancini V, Simonelli M, Ruoppolo G, Genovese E

机构信息

Audiology and Phoniatry Service, Infermi Hospital, Rimini;

ENT Audiology Phoniatry Unit, University of Pisa, Italy;

出版信息

Acta Otorhinolaryngol Ital. 2014 Apr;34(2):105-10.

Abstract

This study evaluated the intra- and inter-rater reliability of the Pooling score (P-score) in clinical endoscopic evaluation of severity of swallowing disorder, considering excess residue in the pharynx and larynx. The score (minimum 4 - maximum 11) is obtained by the sum of the scores given to the site of the bolus, the amount and ability to control residue/bolus pooling, the latter assessed on the basis of cough, raclage, number of dry voluntary or reflex swallowing acts (< 2, 2-5, > 5). Four judges evaluated 30 short films of pharyngeal transit of 10 solid (1/4 of a cracker), 11 creamy (1 tablespoon of jam) and 9 liquid (1 tablespoon of 5 cc of water coloured with methlyene blue, 1 ml in 100 ml) boluses in 23 subjects (10 M/13 F, age from 31 to 76 yrs, mean age 58.56±11.76 years) with different pathologies. The films were randomly distributed on two CDs, which differed in terms of the sequence of the films, and were given to judges (after an explanatory session) at time 0, 24 hours later (time 1) and after 7 days (time 2). The inter- and intra-rater reliability of the P-score was calculated using the intra-class correlation coefficient (ICC; 3,k). The possibility that consistency of boluses could affect the scoring of the films was considered. The ICC for site, amount, management and the P-score total was found to be, respectively, 0.999, 0.997, 1.00 and 0.999. Clinical evaluation of a criterion of severity of a swallowing disorder remains a crucial point in the management of patients with pathologies that predispose to complications. The P-score, derived from static and dynamic parameters, yielded a very high correlation among the scores attributed by the four judges during observations carried out at different times. Bolus consistencies did not affect the outcome of the test: the analysis of variance, performed to verify if the scores attributed by the four judges to the parameters selected, might be influenced by the different consistencies of the boluses, was not significant. These initial data validate the clinical use of the P-score in the management of patients with deglutition disorders by a multidisciplinary team.

摘要

本研究评估了在考虑咽和喉内残留过量的情况下,吞咽障碍严重程度临床内镜评估中合并评分(P评分)的评分者内和评分者间信度。该评分(最低4分 - 最高11分)通过对食团部位、残留/食团合并的量及控制能力的评分相加得出,后者根据咳嗽、清嗓、自主或反射性干吞咽动作次数(<2次、2 - 5次、>5次)进行评估。四名评判员对23名受试者(10名男性/13名女性,年龄31至76岁,平均年龄58.56±11.76岁)的30段咽部通过短片进行了评估,这些短片展示了10个固体食团(四分之一块饼干)、11个乳状食团(1汤匙果酱)和9个液体食团(1汤匙5毫升用亚甲蓝染色的水,100毫升中含1毫升),受试者患有不同疾病。短片随机分布在两张光盘上,光盘上短片顺序不同,在0时(解释性会议后)、24小时后(时间1)和7天后(时间2)分发给评判员。使用组内相关系数(ICC;3,k)计算P评分的评分者间和评分者内信度。考虑了食团一致性可能影响短片评分的可能性。发现部位、量、处理及P评分总分的ICC分别为0.999、0.997、1.00和0.999。吞咽障碍严重程度标准的临床评估仍然是易发生并发症疾病患者管理中的关键环节。源自静态和动态参数的P评分在不同时间进行的观察中,四名评判员给出的评分之间具有非常高的相关性。食团稠度不影响测试结果:为验证四名评判员对所选参数给出的评分是否可能受食团不同稠度影响而进行方差分析,结果不显著。这些初步数据验证了多学科团队在吞咽障碍患者管理中临床使用P评分的可行性。

相似文献

3
The Test of Masticating and Swallowing Solids (TOMASS): Reliability and validity in patients with dysphagia.
Int J Lang Commun Disord. 2021 May;56(3):558-566. doi: 10.1111/1460-6984.12613. Epub 2021 Mar 9.
5
Correlation Between Pharyngeal Residue and Aspiration in Fiber-Optic Endoscopic Evaluation of Swallowing: An Observational Study.
Arch Phys Med Rehabil. 2019 Mar;100(3):488-494. doi: 10.1016/j.apmr.2018.05.028. Epub 2018 Jun 27.
7
Inter- and intra-rater reliability in fibroptic endoscopic evaluation of swallowing.
J Oral Rehabil. 2010 Dec;37(12):884-91. doi: 10.1111/j.1365-2842.2010.02116.x.
8
Dysphagia in Amyotrophic Lateral Sclerosis: Relationships between disease progression and Fiberoptic Endoscopic Evaluation of Swallowing.
Auris Nasus Larynx. 2017 Jun;44(3):306-312. doi: 10.1016/j.anl.2016.07.002. Epub 2016 Aug 25.

引用本文的文献

1
Assessment of upper GI motor activity and GI symptoms in patients with amyotrophic lateral sclerosis: an observational study.
Front Neurol. 2025 Jan 13;15:1509917. doi: 10.3389/fneur.2024.1509917. eCollection 2024.
2
Relationship Between DWI-Based Acute Ischemic Stroke Volume, Location and Severity of Dysphagia.
Brain Sci. 2024 Nov 26;14(12):1185. doi: 10.3390/brainsci14121185.
4
Focal muscle vibrations improve swallowing in persistent dysphagia after traumatic brain injury: A case report.
Turk J Phys Med Rehabil. 2023 May 3;70(2):274-278. doi: 10.5606/tftrd.2023.11351. eCollection 2024 Jun.
8
Evaluating the safety of oral methylene blue during swallowing assessment: a systematic review.
Eur Arch Otorhinolaryngol. 2021 Sep;278(9):3155-3169. doi: 10.1007/s00405-020-06509-3. Epub 2021 Jan 2.

本文引用的文献

3
Structural analysis of muscles elevating the hyolaryngeal complex.
Dysphagia. 2012 Dec;27(4):445-51. doi: 10.1007/s00455-011-9392-7. Epub 2012 Jan 26.
4
Sensory and motor responses of normal young adults during swallowing of foods with different properties and volumes.
Dysphagia. 2010 Sep;25(3):198-206. doi: 10.1007/s00455-009-9243-y. Epub 2009 Aug 13.
5
Flexible endoscopic evaluation of swallowing in healthy young and older adults.
Ann Otol Rhinol Laryngol. 2009 Feb;118(2):99-106. doi: 10.1177/000348940911800204.
6
The bedside examination in dysphagia.
Phys Med Rehabil Clin N Am. 2008 Nov;19(4):747-68, viii. doi: 10.1016/j.pmr.2008.05.008.
7
Defining and measuring dysphagia following stroke.
Am J Speech Lang Pathol. 2009 Feb;18(1):74-81. doi: 10.1044/1058-0360(2008/07-0040). Epub 2008 Oct 16.
8
Intraclass correlations: uses in assessing rater reliability.
Psychol Bull. 1979 Mar;86(2):420-8. doi: 10.1037//0033-2909.86.2.420.
9
Pooling score: an endoscopic model for evaluating severity of dysphagia.
Acta Otorhinolaryngol Ital. 2008 Jun;28(3):135-40.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验