Skip to main content
SpringerLink
Log in

Objective Computer-Based Assessment of Valleculae Residue – Is It Useful?

  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

There have been questions about the reliability of subjective rating scales used to assess valleculae residue from fluoroscopic images. The aim of this study was to assess interrater agreement on one such scale, and compare it with agreement using a new objective measurement scale. Five speech and language therapists rated 100 valleculae residue still images from 20 consecutive patients using standard clinical practice (i.e., subjective visual grading of the videofluoroscopy still and rating as none, mild, moderate, or severe). The images were rerated by the same clinicians using Picture Archiving Communication System measurement tools. The valleculae residue ratio relates the residue size to the size of an individual’s valleculae. A valleculae residue ratio scale was devised using a linear classifier, which defines the cutoff between grades of valleculae residue (none, mild, moderate, and severe). The new method proved at least as reliable as the traditional method; for interrater reliability, kappa = 0.73 vs. 0.73; for intrarater reliability, kappa = 0.87 vs. 0.85. The valleculae residue ratio is proposed as a new quick reliable method of quantifying residue where the Picture Archiving Communication System is available. We now wish to test the impact of this method where poor inter- and intrarater reliability exists.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.
Fig. 3.
Fig. 4.
Fig. 5.
Fig. 6.

Similar content being viewed by others

References

  1. Barczi SR, Sullivan P, Robbins J: How should dysphagia care of older adults differ? Establishing optimal practice patterns. Semin Speech Lang 21(4):347–361, 2000

    Article  PubMed  CAS  Google Scholar 

  2. Lin L, Wu S, Chen H, Wang T, Chen M: Prevalence of impaired swallowing in institutionalized older people in Taiwan. J Am Geriatr Soc 50:1118–1123, 2002

    Article  PubMed  Google Scholar 

  3. Logemann JA: Manual for the videofluorographic study of swallowing. Austin, TX: Pro-Ed, 1993

    Google Scholar 

  4. Veis S, Logemann JA, Colangelo MS: Effects of three techniques on maximum posterior movement of the tongue base. Dysphagia 15:142–145, 2000

    PubMed  CAS  Google Scholar 

  5. Logemann JA: Evaluation and treatment of swallowing disorders. Austin, TX: Pro-Ed, 1998

    Google Scholar 

  6. Eisenhuber E, Schima W, Schober E, Pokieser P, Stadler A, Scharitzer M, Oschatz E: Videofluoroscopic assessment of patients with dysphagia: pharyngeal retention is a predictive factor for aspiration. AJR Am J Roentgenol 178:393–398, 2002

    PubMed  Google Scholar 

  7. Centers for Disease Control and Prevention: Pneumonia and influenza death rates – United States. MMWR Morb Mortal Wkly Rep 44:535–537, 1995

    Google Scholar 

  8. Niederman MS, McCombs JS, Unger AN, Kumar A, Popovian R: The cost of treating community-acquired pneumonia. Clin Therap 20:820–837, 1998

    Article  CAS  Google Scholar 

  9. Palmer JB, Kuhlemeier KV, Tippett DC, Lynch C: A protocol for the videofluorographic swallowing study. Dysphagia 8:209–214, 1993

    Article  PubMed  CAS  Google Scholar 

  10. Ekberg O, Nylander G, Frans-Thomas F, Sjoberg S, Birch-Jensen M, Hillarp B: Interobserver variability in cineradiographic assessment of pharyngeal function during swallow. Dysphagia 3:46–48, 1988

    Article  PubMed  CAS  Google Scholar 

  11. Wilcox F, Liss JM, Siegel GM: Interjudge agreement in videofluoroscopic studies of swallowing. J Speech Hear Res 39:144–152, 1996

    PubMed  CAS  Google Scholar 

  12. McCullough GH, Wertz R, Rosenbek JC, Mills RH, Webb WG, Ross KB: Inter- and intrajudge reliability for videofluoroscopic swallowing evaluation measures. Dysphagia 16:110–118, 2001

    Article  PubMed  CAS  Google Scholar 

  13. Stoeckli SJ, Thierry AGM, Seifert B, Martin-Harris BJW: Inter-rater reliability of videofluoroscopic swallow evaluation. Dysphagia 18:53–57, 2003

    Article  PubMed  Google Scholar 

  14. Kuhlemeier KV, Yates P, Palmer J: Intra- and inter-rater variations in the evaluation of videofluorographic swallowing studies. Dysphagia 13:142–147, 1998

    Article  PubMed  CAS  Google Scholar 

  15. Ott D: Observer variation in evaluation of videofluoroscopic swallowing studies: a continuing problem [editorial]. Dysphagia 13:148–150, 1998

    PubMed  CAS  Google Scholar 

  16. Dejaeger E: Mechanisms involved in postdeglutition retention in the elderly. Dysphagia 12:63–67, 1997

    Article  PubMed  CAS  Google Scholar 

  17. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL: A penetration-aspiration scale. Dysphagia 11:93–98, 1996

    Article  PubMed  CAS  Google Scholar 

  18. Galli J, Valenanzio V, Ottaviani F, D’Alatri L, Almadori G, D’Errico G, Serra F, De Rossi G, Paludetti G: Scintigraphic assessment of swallowing after horizontal supraglottic laryngectomy. J Otolaryngol 28:190–196, 1999

    Google Scholar 

  19. Shaw DW, Williams RBH, Cook IJ, Wallace KL, Weltman MB, Collins PJ, McKay E, Smart R, Simula ME: Oropharyngeal scintigraphy: a reliable technique for the quantitative evaluation of oral-pharyngeal swallowing. Dysphagia 19:36–42, 2004

    Article  PubMed  CAS  Google Scholar 

  20. Hind JA, Nicosia MA, Roecker EB, Carnes ML, Robbins J: Comparison of effortful and non-effortful swallows in healthy middle-aged and older adults. Arch Phys Med Rehabil 82:1661–1665, 2001

    Article  PubMed  CAS  Google Scholar 

  21. Han T, Nam-Jong P, Park JW: Quantifying swallowing function after stroke: A functional dysphagia scale based on videofluoroscopic studies. Arch Phys Med Rehabil 82:677–682, 2001

    Article  PubMed  CAS  Google Scholar 

  22. International Society of Optical Engineering: Proceeding of the first international conference and workshop on picture archiving communication systems. January 18th-21st (1982), Newport Beach, California, Published by Bellingham, Washington

  23. Huang HK: PACS: basic principles and applications. New York: Wiley-Liss, 1999

    Google Scholar 

  24. Friedman JH: Regularized discriminant analysis. J Am Stat Assoc 84:165–175, 1989

    Article  Google Scholar 

  25. Landis J, Koch G: The measurement of observer agreement for categorical data. Biometrics 33:159–174, 1977

    Article  PubMed  CAS  Google Scholar 

  26. Mathers-Schmidt BA, Kurlinski M: Dysphagia evaluation practices: inconsistencies in clinical assessment and instrumental examination decision-making. Dysphagia 18:114–125, 2003

    Article  PubMed  Google Scholar 

  27. NHS National Programme for Information Technology: Making IT work. 1:15, 2004 (available at: http://www.dh.gov.uk/assetRoot/04/07/71/57/04077157.pdf)

  28. Ekberg O, Feinberg M: Altered swallowing function in elderly patients without dysphagia: radiologic findings in 56 cases AJR Am J Roentgenol 156:1181–1184, 1991

    PubMed  CAS  Google Scholar 

  29. Cook IJ, Weltman MD, Wallace K, Shaw DW, McKay E, Smart RC, Butler SP: Influence of ageing on oral-pharyngeal bolus transit and clearance during swallowing: scintigraphic study. Am J Physiol 266:G972–G977, 1994

    PubMed  CAS  Google Scholar 

  30. Marik PE, Kaplan D: Aspiration pneumonia and dysphagia in the elderly. Chest 124(1):328–336, 2003

    Article  PubMed  Google Scholar 

  31. Pedersen DR, Lamb CA, Dolan L, Ralston H, Weinstein S, Morcuende J: Radiographic measurements in development dysplasia of the hip. J Pediatr Orthop 24:156–160, 2004

    PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank the 20 patients who volunteered to participate in this study; the five Speech and Language Pathologists who rated the stills; the five designated radiographers who captured the videofluoroscopy images; Dr. DeSai, Consultant Radiologist, Val Gleason, Superintendent Radiographer, and Mark Brennan, PACS technician, for their support throughout this challenging study; and Linda Templey, Director of Primary and Community Care, Durham and Chester-le-Street PCT (now assimilated into County Durham PCT) for agreeing to sponsor this research.

Author information

Authors and Affiliations

  1. Department of Speech and Language Therapy, University Hospital North Durham, North Road, Durham, DH1 5TW, UK

    Jill C. Dyer MSc, BSc(Hons)

  2. School of Surgical and Reproductive Sciences, The Medical School, University of Newcastle, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK

    Paula Leslie PhD

  3. Regional Medical Physics, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK

    Michael J. Drinnan PhD

Authors
  1. Jill C. Dyer MSc, BSc(Hons)
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paula Leslie PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael J. Drinnan PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jill C. Dyer MSc, BSc(Hons).

Additional information

This work was supported by Durham and Chester-le-Street Primary Care Trust (now assimilated into County Durham Primary Care Trust). Work was performed at University Hospital North Durham, North Road, Durham, DH1 5TW, UK.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dyer, J.C., Leslie, P. & Drinnan, M.J. Objective Computer-Based Assessment of Valleculae Residue – Is It Useful?. Dysphagia 23, 7–15 (2008). https://doi.org/10.1007/s00455-007-9088-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-007-9088-1

Keywords

Search

Navigation