Hey C, Pluschinski P, Stöver T, Zaretsky Y
Schwerpunkt für Phoniatrie und Pädaudiologie, Klinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Frankfurt am Main.
Klinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Frankfurt am Main.
Laryngorhinootologie. 2015 Mar;94(3):169-72. doi: 10.1055/s-0034-1385848. Epub 2014 Aug 11.
Accumulation of secretions in hypopharynx, aditus vestibule, and trachea is often found in cases of severe dysphagia and is considered a cardinal trait of high clinical and therapeutic importance. For the graduation of the severity level of accumulated secretions, a short version of the 4-point Murray secretion scale is available, which is also integrated into the protocol of the fiberoptic endoscopic evaluation of swallowing (FEES) according to the Langmore standard. This study aimed at the validation of the German translation of this short version in order to facilitate a uniform, standardized evaluation of the accumulation of secretions in dysphagic patients in the German language area.
For the examination of reliability and validity, a reference standard was defined by 2 dysphagia experts on the basis of 40 video files of the FEES examination, 10 videos for each of the severity grades. Afterwards, these videos were rated independently by 4 raters and re-rated in a new randomized order 2 weeks later.
Both the intra-rater reliability (τ>0,830***) and the inter-rater reliability (Kendalls W>0,890***) were highly significant and can be considered good. The same is valid for the correlation of ratings with the reference standard (τ=0,969***).
The German translation of the short version of the 4-point Murray secretion scale is recommendable as a reliable and valid instrument for the graduation of the cardinal trait of oropharyngeal dysphagia and also as an evidence-based instrument for standardized use in the German language area.
下咽、前庭入口和气管分泌物积聚在严重吞咽困难病例中经常出现,被认为是具有高度临床和治疗重要性的主要特征。对于分泌物积聚严重程度的分级,有一个简短版的4分穆雷分泌物量表可供使用,该量表也根据朗莫尔标准被纳入纤维内镜吞咽评估(FEES)方案中。本研究旨在验证该简短版的德语翻译,以便在德语区对吞咽困难患者的分泌物积聚情况进行统一、标准化的评估。
为了检验信度和效度,由2名吞咽困难专家根据40个FEES检查的视频文件定义了一个参考标准,每个严重程度等级有10个视频。之后,4名评分者对这些视频进行独立评分,并在2周后以新的随机顺序重新评分。
评分者内信度(τ>0.830***)和评分者间信度(肯德尔W>0.890***)都非常显著,可以认为良好。评分与参考标准的相关性(τ=0.969***)也是如此。
4分穆雷分泌物量表简短版的德语翻译作为一种可靠且有效的工具,可用于口咽吞咽困难主要特征的分级,也是德语区标准化使用的循证工具,值得推荐。