The Boston Residue and Clearance Scale: preliminary reliability and validity testing

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Gastroenterology

Background:

• No validated scale exists for rating post-swallowing residue.
• The Boston Residue and Clearance Scale (BRACS) was developed to address this gap.
• Initial assessment of BRACS reliability and validity was performed.

Purpose of the Study:

• To develop and validate the Boston Residue and Clearance Scale (BRACS).
• To assess the reliability and validity of BRACS for residue rating during FEES.

Main Methods:

• BRACS is an 11-point scale evaluating residue amount, location, and clearing effectiveness during FEES.
• Inter-rater and test-retest reliability were assessed using 63 swallows scored by 4 raters.
• Concurrent validity was tested against clinical judgment, and internal consistency was examined.

Main Results:

• BRACS demonstrated excellent inter-rater reliability (ICC = 0.81) and test-retest reliability (ICC: 0.82-0.92).
• High concurrent validity (Pearson's r = 0.76) and internal consistency (Cronbach's α = 0.86) were found.
• Factor analysis identified 3 latent factors within the 12 location items.

Conclusions:

• The Boston Residue and Clearance Scale (BRACS) is a valid and reliable instrument.
• BRACS effectively rates the severity of residue after swallowing.
• This scale can be a valuable tool in clinical practice for FEES evaluations.