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Interobserver agreement on normal swallowing physiology as viewed by videoendoscopy
J A Logemann1, A W Rademaker, B R Pauloski
1Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA. j-logemann@nwu.edu
Summary
Observer agreement in videonasendoscopy for swallowing assessment reached 83% for normal oropharyngeal swallow events. Endoscopic position impacted agreement, but bolus volume did not, guiding future observer training.
Area of Science:
- Otolaryngology
- Swallowing Physiology
- Diagnostic Imaging
Background:
- Accurate assessment of oropharyngeal swallowing is crucial for diagnosing and managing dysphagia.
- Videonasendoscopy is a common tool for evaluating swallowing function.
- Standardizing observer interpretation is essential for reliable diagnostic outcomes.
Purpose of the Study:
- To evaluate inter-observer agreement in identifying normal oropharyngeal swallow events using videonasendoscopy.
- To determine the influence of endoscopic position and bolus volume on observer agreement.
- To inform training needs for endoscopic swallowing assessments.
Main Methods:
- Two observers assessed videonasendoscopic recordings of 1-ml and 5-ml water swallows in 3 healthy young adults.
- Recordings were analyzed from two distinct endoscopic positions: high (near uvula) and low (near epiglottis).
- Agreement on the onset and termination of 12 specific swallow events was calculated.
Main Results:
- Overall inter-observer agreement for identifying swallow events was 83%.
- Endoscopic position significantly affected observer agreement on several swallow events.
- Bolus volume (1 ml vs. 5 ml) did not influence observer agreement.
Conclusions:
- Observer agreement in videonasendoscopic swallowing evaluations is substantial but can be influenced by procedural factors.
- Endoscopic positioning is a critical variable affecting reliability in swallowing assessments.
- Targeted training focusing on optimal scope positioning can enhance consistency in videonasendoscopic swallowing evaluations.