A reliability study of a clinical evaluation and coordinate mapping protocol for videofluoroscopic swallowing study analysis by inexperienced judges

Abstract

Videofluoroscopic Swallowing Study (VFSS) has been widely used in clinical settings for evaluating swallowing dysfunctions. Past studies that investigated clinicians’ VFSS interpretations reported varying reliabilities. The analysis of VFSS required subjective judgments that might be affected by the clinical knowledge and experience of the clinicians. It was suggested that additional clinician trainings could improve the reliability of VFSS judgments. In 2014, Thompson and colleagues reported excellent reliabilities in using the quantitative Coordinate Mapping protocol for VFSS analysis (Thompson et al., 2014). 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 Coordinate Mapping (CM) protocol for analyzing VFSS. Forty inexperienced judges received training to perform VFSS judgments using either evaluation protocol. Results revealed 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 in one out of three rating parameters than the CM group after training. It was recommended that resources could be allocated in providing clinician trainings and promoting the CM protocol, in order to improve the reliabilities of current subjective evaluation protocols for VFSS.