改良钡吞咽障碍评估量表的结构效度、内部一致性和评估者可靠性：基于 52726 例患者临床数据集的探索。
Structural Validity, Internal Consistency, and Rater Reliability of the Modified Barium Swallow Impairment Profile: Breaking Ground on a 52,726-Patient, Clinical Data Set.
机构信息
Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL.
Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston.
出版信息
J Speech Lang Hear Res. 2022 May 11;65(5):1659-1670. doi: 10.1044/2022_JSLHR-21-00554. Epub 2022 Mar 30.
PURPOSE
The purpose of this study was to extend the assessment of the psychometric properties of the Modified Barium Swallow Impairment Profile (MBSImP). Here, we re-examined structural validity and internal consistency using a large clinical-registry data set and formally examined rater reliability in a smaller data set.
METHOD
This study consists of a retrospective structural validity and internal consistency analysis of MBSImP using a large data set ( = 52,726) drawn from the MBSImP Swallowing Data Registry and a prospective study of the interrater and intrarater reliability of a subset of studies ( = 50) rated by four MBSImP-trained speech-language pathologists. Structural validity was assessed via exploratory factor analysis. Internal consistency was measured using Cronbach's alpha for each of the multicomponent MBSImP domains, namely, the oral and pharyngeal domains. Interrater reliability and intrarater reliability were measured using the intraclass correlation coefficient (ICC).
RESULTS
The exploratory factor analysis showed a two-factor solution with factors precisely corresponding to the scale's oral and pharyngeal domains, consistent with findings from the initial study. Component 17, that is, the esophageal domain, did not load onto either factor. Internal consistency was good for both the oral and pharyngeal domains (α = .81, α = .87). Interrater reliability was found to be good with ICC = .78 (95% confidence interval [CI; .76, .80]). Intrarater reliability was good for each rater, ICC = .82 (95% CI [.77, .86]), ICC = .83 (95% CI [.79, .87]), ICC = .87 (95% CI [.83, .90]), and ICC = .87 (95% CI [.83, .90]).
CONCLUSIONS
This study leverages a large-scale, clinical data set to provide strong, generalizable evidence that the MBSImP assessment method has excellent structural validity and internal consistency. In addition, the results show that MBSImP-trained speech-language pathologists can demonstrate good interrater and intrarater reliability.
目的
本研究旨在扩展改良巴氏吞咽障碍量表（MBSImP）的心理测量学特性评估。在这里，我们使用大型临床注册数据库重新检查了结构有效性和内部一致性，并在较小的数据集上正式检查了评分者间信度。
方法
本研究通过使用从 MBSImP 吞咽数据注册中心提取的大型数据集（n=52726）对 MBSImP 进行回顾性结构有效性和内部一致性分析，以及对由四名接受 MBSImP 培训的言语语言病理学家评定的研究子集（n=50）的评分者间和评分者内信度进行前瞻性研究。结构有效性通过探索性因子分析进行评估。内部一致性通过每个多成分 MBSImP 域（即口腔和咽部域）的 Cronbach's alpha 进行测量。评分者间信度和评分者内信度使用组内相关系数（ICC）进行测量。
结果
探索性因子分析显示出两个因子解决方案，因子与量表的口腔和咽部域完全对应，与初始研究的结果一致。第 17 个成分，即食管域，未加载到任何一个因子上。口腔和咽部域的内部一致性良好（α=0.81，α=0.87）。评分者间信度良好，ICC=0.78（95%置信区间[CI]：0.76，0.80）。每位评分者的评分者内信度良好，ICC=0.82（95%CI[0.77，0.86]），ICC=0.83（95%CI[0.79，0.87]），ICC=0.87（95%CI[0.83，0.90]）和 ICC=0.87（95%CI[0.83，0.90]）。
结论
本研究利用大规模临床数据集提供了强有力的、可推广的证据，表明 MBSImP 评估方法具有极好的结构有效性和内部一致性。此外，结果表明，接受 MBSImP 培训的言语语言病理学家可以表现出良好的评分者间和评分者内信度。
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