Scott A, Perry A, Bench J
School of Human Communication Sciences, La Trobe University, Bundoora, Victoria, Australia.
Dysphagia. 1998 Fall;13(4):223-7. doi: 10.1007/PL00009576.
Videofluoroscopic assessment of swallowing is widely used in clinical settings. The interpretation of such assessments depends on subjective visual judgments but the reliability of these judgments has been poorly researched. This study measured interrater reliability of judgments, made by speech pathologists, of videofluoroscopic images of subjects swallowing liquid and semisolid boluses. A 5-point rating scale was used in three conditions: individually after careful reading; together with other speech pathologists in group discussion; and individually after the group discussion. Analysis of the ratings for the three conditions revealed that the level of agreement among raters was generally higher for semisolid swallows than for liquid swallows. The highest levels of agreement occurred for ratings made after group discussions. The levels of agreement were lowest when raters worked alone, relying only on reading the scale. Individual rating after group discussion resulted in higher levels of agreement than sole reliance on reading the scale. Factors influencing the levels of interrater agreement, including the timing of observations, bolus consistency, the quality of the image, and the complexity of the task, are discussed.
吞咽的视频荧光评估在临床环境中被广泛使用。此类评估的解读依赖于主观视觉判断，但这些判断的可靠性研究较少。本研究测量了言语病理学家对受试者吞咽液体和半固体食团的视频荧光图像判断的评分者间信度。在三种情况下使用了5分制评分量表：仔细阅读后单独评分；在小组讨论中和其他言语病理学家一起评分；小组讨论后单独评分。对这三种情况评分的分析表明，评分者之间的一致程度对于半固体吞咽通常高于液体吞咽。小组讨论后进行的评分一致性最高。评分者单独工作、仅依靠阅读量表时，一致程度最低。小组讨论后单独评分比仅依靠阅读量表产生更高的一致程度。文中讨论了影响评分者间一致程度的因素，包括观察时间、食团稠度、图像质量和任务复杂性。
