IRCCS San Camillo Hospital, Venice, Italy.
Department of Neuroscience, Section of Otolaryngology, Azienda Ospedale-Università Padova, Padua, Italy.
Acta Otorhinolaryngol Ital. 2023 Feb;43(1):12-19. doi: 10.14639/0392-100X-N2289.
In the dysphagic patient, pharyngeal residues (PR) are associated with aspiration and poor quality of life. The assessment of PR using validated scales during flexible endoscopic evaluation of swallowing (FEES) is crucial for rehabilitation. This study aims to validate and test the reliability of the Italian version of the Yale Pharyngeal Residue Severity Rating Scale (IT-YPRSRS). The effects of training and experience in FEES on the scale were also determined.
The original YPRSRS was translated into Italian according to standardised guidelines. Thirty FEES images were selected after consensus and proposed to 22 naive raters who were asked to assess the severity of PR in each image. Raters were divided into two subgroups by years of experience at FEES, and randomly by training. Construct validity, inter-rater, and intra-rater reliability were assessed by kappa statistics.
IT-YPRSRS showed substantial to almost perfect agreement (kappa > 0.75) in validity and reliability for both the overall sample (660 ratings), and valleculae/pyriform sinus sites (330 ratings each). No significant differences emerged between groups considering years of experience, and variable differences were observed by training.
The IT-YPRSRS demonstrated excellent validity and reliability in identifying location and severity of PR.
在吞咽困难的患者中,咽部残留物(PR)与吸入和生活质量差有关。使用经证实的量表在灵活的内镜吞咽评估(FEES)中评估 PR 对于康复至关重要。本研究旨在验证和测试意大利语版耶鲁咽残留严重程度评分量表(IT-YPRSRS)的可靠性。还确定了在 FEES 中培训和经验对该量表的影响。
根据标准指南将原始 YPRSRS 翻译成意大利语。在达成共识后选择了 30 个 FEES 图像,并将其提供给 22 名对该量表不熟悉的评估者,要求他们评估每张图像中 PR 的严重程度。评估者根据在 FEES 方面的经验年限以及培训随机分为两个小组。kappa 统计用于评估构效关系、组内和组间的可靠性。
在整个样本(660 次评分)和 valleculae/pyriform sinus 部位(每个部位 330 次评分)中,IT-YPRSRS 在有效性和可靠性方面均表现出实质性到几乎完美的一致性(kappa > 0.75)。考虑到经验年限,组间没有出现显著差异,而培训则观察到了可变差异。
IT-YPRSRS 在识别 PR 的位置和严重程度方面表现出极好的有效性和可靠性。