Inter- and intrajudge reliability for videofluoroscopic swallowing evaluation measures

Area of Science:

• Medical imaging
• Speech-language pathology
• Clinical assessment

Background:

• Interjudge reliability in videofluoroscopic swallowing evaluations is often poor.
• Limited data exists on intrajudge reliability for frame-by-frame videofluoroscopic swallowing analysis.
• Standardized VFS measures are crucial for consistent dysphagia assessment.

Purpose of the Study:

• To assess the inter- and intrajudge reliability of commonly used videofluoroscopic swallowing evaluation measures.
• To investigate the consistency of VFS swallowing assessments performed by clinicians.
• To identify specific VFS measures that exhibit reliable scoring.

Main Methods:

• Twenty stroke patients underwent videofluoroscopic swallowing examinations.
• Three experienced clinicians rated the VFS examinations from videotape using frame-by-frame analysis.
• No specific training was provided to the clinicians before the assessment.

Main Results:

• High intrajudge reliability was observed for several VFS measures, indicating consistent scoring by individual clinicians.
• Unacceptable interjudge reliability was found, suggesting variability in how different clinicians interpret VFS findings.
• Clinician experience correlated with consistent intrajudge scoring but not necessarily with interjudge agreement.

Conclusions:

• Experienced clinicians can achieve reliable intrajudge scoring for certain videofluoroscopic swallowing measures.
• Significant interjudge variability highlights the need for standardized training and criteria in VFS evaluations.
• Improving interjudge reliability is essential for accurate and consistent dysphagia diagnosis and management.