Rocca Sara, Pizzorni Nicole, Valenza Nadia, Negri Luca, Schindler Antonio
Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy.
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy.
Diagnostics (Basel). 2022 Aug 4;12(8):1897. doi: 10.3390/diagnostics12081897.
The Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) provides an image-based assessment of pharyngeal residue in the fiberoptic endoscopic evaluation of swallowing (FEES). Its performance was investigated only in FEES frames. This study analyzed the reliability and construct validity of the YPRSRS in FEES videos and the influence of bolus consistency. Thirty pairs of FEES videos and frames, 8 thin liquids (<50 mPa·s), 11 pureed (2583.3 mPa·s at 50 s−1, 697.87 mPa·s at 300 s−1), and 11 solid food; were assessed by 29 clinicians using the YPRSRS; 14 raters re-assessed materials at least 15 days from the first evaluation. Construct validity and intra-rater reliability were assessed using weighted Cohen’s Kappa. Inter-rater reliability was assessed using weighted Fleiss Kappa. Construct validity and inter-rater reliability were almost perfect or excellent for frames (0.82 ≤ k ≤ 0.89) and substantial or intermediate to good for videos (0.67 ≤ k ≤ 0.79). Intra-rater reliability was almost perfect for both frames and videos (k ≥ 0.84). Concerning bolus consistency, thin liquids had significantly lower values of construct validity, intra-, and inter-rater reliability than pureed and solid food. Construct validity and inter-rater reliability were significantly lower for solid food than for pureed food. The YPRSRS showed satisfactory reliability and construct validity also in FEES videos. Reliability was significantly influenced by bolus consistency.
耶鲁咽残留严重程度评定量表（YPRSRS）在吞咽功能的纤维内镜评估（FEES）中提供了基于图像的咽残留评估。其性能仅在FEES图像中进行了研究。本研究分析了YPRSRS在FEES视频中的信度和结构效度以及食团黏稠度的影响。29名临床医生使用YPRSRS对30对FEES视频和图像进行了评估，其中包括8种稀液体（<50 mPa·s）、11种泥状食物（50 s−1时为2583.3 mPa·s，300 s−1时为697.87 mPa·s）和11种固体食物；14名评估者在首次评估至少15天后对材料进行了重新评估。使用加权科恩kappa系数评估结构效度和评估者内信度。使用加权弗莱斯kappa系数评估评估者间信度。对于图像，结构效度和评估者间信度几乎为完美或优秀（0.82≤κ≤0.89），对于视频则为中等或良好（0.67≤κ≤0.79）。评估者内信度对于图像和视频均几乎为完美（κ≥0.84）。关于食团黏稠度，稀液体的结构效度、评估者内和评估者间信度值显著低于泥状食物和固体食物。固体食物的结构效度和评估者间信度显著低于泥状食物。YPRSRS在FEES视频中也显示出令人满意的信度和结构效度。信度受食团黏稠度的显著影响。
