A comparison of two rating protocols for videofluoroscopic swallowing study by inexperienced judges

Abstract

Purpose: Videofluoroscopic swallowing study (VFSS) has been widely used in clinical settings and in research for evaluating swallowing functions. The interpretation of such studies requires subjective judgment by the raters, which may be affected by clinical experience and definitions of the rating parameters. Two methods have been proposed to improve the reliability: training and use of a coordinate mapping (CM) protocol. This study aimed at investigating the effect of training on improving the intra-and inter-rater reliabilities of VFSS analysis; and comparing the intra- and inter-rater reliabilities of a clinical evaluation (CE) protocol and a CM protocol for analysing VFSS. Method: Forty inexperienced judges were randomly assigned to one of two groups: a CE group or a CM group. Each group received training to perform VFSS judgments using the relevant analysis protocol. All participants were tested individually before and after training. Result: Results showed that training significantly improved the intra- and inter-rater reliabilities of both protocols. In addition, the CE group achieved significantly higher intra- and inter-rater reliabilities than the CM group after training. Conclusion: It is recommended that standard training protocols be implemented during clinical training to improve the reliability in VFSS analysis.