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Validation of the German Version of the Yale Pharyngeal Residue Severity Rating Scale

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Abstract

The aim of this study was to validate the German Version of the Yale Pharyngeal Residue Severity Rating Scale and to investigate the impact of rater experience and training. The English original scale was translated into German language using a forward–backward method. For the validation, 30 images of different pharyngeal residue amounts have been selected and assigned to the scales’ severity levels by two experts. 28 raters rated the images in randomized order in two passes. To investigate the impact of experience and training, raters were grouped into subgroups. Statistical analysis was carried out using kappa statistics. The results demonstrate excellent residue ratings for construct validity, inter-rater reliability and intra-rater reliability regarding overall group and all subgroups (Kappa > 0.90). No significant differences were found between groups by experience and inconstant differences were found between groups by training. The German version of the Yale Pharyngeal Residue Severity Rating Scale is a valid, reliable instrument for scoring location and severity of pharyngeal residue in the context of flexible endoscopic evaluations of swallowing.

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References

  1. Murray J, Langmore SE, Ginsberg S, Dostie A. The significance of accumulated oropharyngeal secretions and swallowing frequency in predicting aspiration. Dysphagia. 1996;11:99–103. https://doi.org/10.1007/BF00417898.

    Article  CAS  PubMed  Google Scholar 

  2. dos Santos RRD, Sales AVMN, Cola PC, et al. Association between pharyngeal residue and posterior oral spillage with penetration and aspiration in Stroke. CoDAS. 2014;26:231–4. https://doi.org/10.1590/2317-1782/201420140476.

    Article  PubMed  Google Scholar 

  3. Schiele JT, Penner H, Schneider H, et al. Swallowing tablets and capsules increases the risk of penetration and aspiration in patients with stroke-induced dysphagia. Dysphagia. 2015;30:571–82. https://doi.org/10.1007/s00455-015-9639-9.

    Article  PubMed  Google Scholar 

  4. Leder SB, Lerner MZ. Nil per os except medications order in the dysphagic patient. QJM. 2013;106(1):71–5. https://doi.org/10.1093/qjmed/hcs044.

    Article  CAS  PubMed  Google Scholar 

  5. Meyer TK, Pisegna JM, Krisciunas GP, Pauloski BR, Langmore SE. Residue influences quality of life independently of penetration and aspiration in head and neck cancer survivors: residue affects both QoL and function. Laryngoscope. 2017;127:1615–21. https://doi.org/10.1002/lary.26387.

    Article  CAS  PubMed  Google Scholar 

  6. Langmore SE, Kenneth SMA, Olsen N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia. 1988;2:216–9. https://doi.org/10.1007/BF02414429.

    Article  CAS  PubMed  Google Scholar 

  7. Langmore S. Endoscopic evaluation and treatment of swallowing disorders. 2nd ed. New York: Thieme; 2001. ISBN 978-0-86577-838-2.

    Google Scholar 

  8. Schatz K, Langmore SE, Olson N. Endoscopic and videofluoroscopic evaluations of swallowing and aspiration. Ann Otol Rhinol Laryngol. 1991;100:678–81. https://doi.org/10.1177/000348949110000815.

    Article  PubMed  Google Scholar 

  9. Suntrup S, Meisel A, Dziewas R, Ende F, Reichmann H, Heuschmann P, Ickenstein GW. Dysphagia diagnostics and therapy of acute stroke: federal survey of certified stroke units. Nervenarzt. 2012;83:1619–24. https://doi.org/10.1007/s00115-012-3611-9.

    Article  CAS  PubMed  Google Scholar 

  10. Dziewas R, Glahn J, Helfer C, et al. Flexible endoscopic evaluation of swallowing (FEES) for neurogenic dysphagia: training curriculum of the German Society of Neurology and the German stroke society. BMC Med Educ. 2016;16:70. https://doi.org/10.1186/s12909-016-0587-3.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Dziewas R, Baijens L, Schindler A, Verin E, Michou E, Clave P, The European Society for Swallowing Disorders. European society for swallowing disorders FEES accreditation program for neurogenic and geriatric oropharyngeal dysphagia. Dysphagia. 2017;32:725–33. https://doi.org/10.1007/s00455-017-9828-9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Kelly AM, Leslie P, Beale T, Payten C, Drinnan MJ. Fibreoptic endoscopic evaluation of swallowing and videofluoroscopy: does examination type influence perception of pharyngeal residue severity. Clin Otolaryngol. 2006;31:425–32. https://doi.org/10.1111/j.1749-4486.2006.01292.x.

    Article  CAS  PubMed  Google Scholar 

  13. Pisegna JM, Langmore SE. Parameters of instrumental swallowing evaluations: describing a diagnostic dilemma. Dysphagia. 2016;31:462–72. https://doi.org/10.1007/s00455-016-9700-3.

    Article  PubMed  Google Scholar 

  14. Langmore SE. History of fiberoptic endoscopic evaluation of swallowing for evaluation and management of pharyngeal dysphagia: changes over the years. Dysphagia. 2017;32:27–38. https://doi.org/10.1007/s00455-016-9775-x.

    Article  PubMed  Google Scholar 

  15. Neubauer PD, Hersey DP, Leder SB. Pharyngeal residue severity rating scales based on fiberoptic endoscopic evaluation of swallowing: a systematic review. Dysphagia. 2016;31:352–9. https://doi.org/10.1007/s00455-015-9682-6.

    Article  PubMed  Google Scholar 

  16. Pisegna JM, Borders JC, Kaneoka A, Coster WJ, Leonard R, Langmore SE. Reliability of untrained and experienced raters on FEES: rating overall residue is a simple task. Dysphagia. 2018. https://doi.org/10.1007/s00455-018-9883-x.

    Article  PubMed  Google Scholar 

  17. Pisegna JM, Kaneoka A, Leonard R, Langmore SE. Rethinking residue: determining the perceptual continuum of residue on FEES to enable better measurement. Dysphagia. 2018;33(1):100–8. https://doi.org/10.1007/s00455-017-9838-7.

    Article  PubMed  Google Scholar 

  18. Neubauer PD, Rademaker AW, Leder SB. The Yale pharyngeal residue severity rating scale: an anatomically defined and image-based tool. Dysphagia. 2015;30:521–8. https://doi.org/10.1007/s00455-015-9631-4.

    Article  PubMed  Google Scholar 

  19. Leder SB, Neubauer PD. The Yale pharyngeal residue severity rating scale. Cham: Springer; 2016. ISBN 978-3-319-29899-3.

    Book  Google Scholar 

  20. Schmitt M, Eid M. Guidelines for the translation of foreign-language measurement instruments. Diagnostica. 2007;53:1–2. https://doi.org/10.1026/0012-1924.53.1.1.

    Article  Google Scholar 

  21. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25:3186–91.

    Article  CAS  PubMed  Google Scholar 

  22. Mayring P. Qualitative inhaltsanalyse: grundlagen und techniken. 12th ed. Weinheim: Beltz; 2015. ISBN 978-3-407-25730-7.

    Google Scholar 

  23. de Vet HCW, Terwee CB, Mokkink LB, Knol DL. Measurement in medicine: a practical guide. New York: Cambridge University Press; 2011. ISBN 978-0-521-13385-2.

    Book  Google Scholar 

  24. Urbaniak GC, Plous S. Research randomizer (Version 4.0) [computer software]; 2013. http://www.randomizer.org/.

  25. Gwet KL. Testing the difference of correlated agreement coefficients for statistical significance. Educ Psychol Meas. 2016;76:609–37. https://doi.org/10.1177/0013164415596420.

    Article  PubMed  Google Scholar 

  26. Klein D. KAPPAETC: Stata module to evaluate interrater agreement. Statistical Software Components S458283, Boston College Department of Economics; 2016. https://ideas.repec.org/c/boc/bocode/s458283.html.

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Acknowledgement

The authors gratefully acknowledge Paul D. Neubauer, Yale School of Medicine for providing the original images and Daniel Klein, University of Kassel for his support and consultation with his Stata command “kappaetc.”

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Authors and Affiliations

  1. Department of Neurology and Neurorehabilitation, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Germany

    Marco Gerschke & Annette Förster

  2. Faculty of Social Work and Health, HAWK University of Applied Sciences and Arts Hildesheim, Goschentor 1, 31134, Hildesheim, Germany

    Thomas Schöttker-Königer & Ulla Marie Beushausen

  3. Department of Speech- and Language Therapy, P.A.N. Center for Post-acute Neurorehabilitation, Wildkanzelweg 28, 13465, Berlin, Germany

    Jonka Friederike Netzebandt

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  1. Marco Gerschke
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  2. Thomas Schöttker-Königer
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  3. Annette Förster
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  4. Jonka Friederike Netzebandt
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  5. Ulla Marie Beushausen
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Correspondence to Marco Gerschke.

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Written informed consent was obtained from all the participants before participation in this study.

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Gerschke, M., Schöttker-Königer, T., Förster, A. et al. Validation of the German Version of the Yale Pharyngeal Residue Severity Rating Scale. Dysphagia 34, 308–314 (2019). https://doi.org/10.1007/s00455-018-9935-2

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  • DOI: https://doi.org/10.1007/s00455-018-9935-2

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