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- Publisher Website: 10.1111/nmo.12610
- Scopus: eid_2-s2.0-84937971681
- PMID: 26031361
- WOS: WOS:000364747100017
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Article: Inter-rater reliability and validity of automated impedance manometry analysis and fluoroscopy in dysphagic patients after head and neck cancer radiotherapy
Title | Inter-rater reliability and validity of automated impedance manometry analysis and fluoroscopy in dysphagic patients after head and neck cancer radiotherapy |
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Authors | |
Keywords | Videofluoroscopy Impedance Manometry Reliability Dysphagia Pharynx |
Issue Date | 2015 |
Citation | Neurogastroenterology and Motility, 2015, v. 27, n. 8, p. 1183-1189 How to Cite? |
Abstract | Background: Pharyngeal automated impedance manometry (AIM) analysis is a novel non-radiological method to analyze swallowing function based on impedance-pressure recordings. In dysphagic head and neck cancer patients, we evaluated the reliability and validity of the AIM-derived swallow risk index (SRI) and a novel measure of postswallow residue (iZn/Z) by comparing it against videofluoroscopy as the gold standard. Methods: Three blinded experts classified 88 videofluoroscopic swallows from 16 patients for aspiration and degree of postswallow residue. Pressure-impedance recordings of the patient and age-matched control swallows were analyzed using AIM by three observers who derived the SRI and iZn/Z. Intra-class correlation coefficients (ICC) were calculated for videofluoroscopic and AIM measures. Patient pressure/impedance measurements were compared with videofluoroscopy scores and control subjects to determine validity for detecting clinically relevant swallowing dysfunction. Key Results: Agreement among observers assessing presence of penetration and aspiration was modest (ICC 0.57) for videofluoroscopy and good (ICC 0.71, 0.82) for AIM-derived SRI and iZn/Z. When compared with age-matched controls, the SRI was higher in patients with aspiration (mean diff. 28.6, 95% CI [55.85, 1.355], p < 0.05). The iZn/Z had moderate positive correlation with bolus residue on fluoroscopy (BRS score) (rs(86) = 0.4120, p < 0.0001) and was increased in both patients with aspiration ({increment}244 [419.7, 69.52; p < 0.05]) and penetration ({increment}240 [394.3, 85.77]; p < 0.05) compared to controls. Conclusions & Inferences: AIM-based measures of swallowing function have better inter-rater reliability than comparable fluoroscopically derived measures. These measures are easily determined and objective markers of clinically relevant features of disordered swallowing following radiotherapy. |
Persistent Identifier | http://hdl.handle.net/10722/301792 |
ISSN | 2023 Impact Factor: 3.5 2023 SCImago Journal Rankings: 1.312 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Szczesniak, Michal M. | - |
dc.contributor.author | Maclean, J. | - |
dc.contributor.author | Zhang, T. | - |
dc.contributor.author | Liu, R. | - |
dc.contributor.author | Cock, C. | - |
dc.contributor.author | Rommel, N. | - |
dc.contributor.author | Omari, T. I. | - |
dc.contributor.author | Cook, I. J. | - |
dc.date.accessioned | 2021-08-19T02:20:45Z | - |
dc.date.available | 2021-08-19T02:20:45Z | - |
dc.date.issued | 2015 | - |
dc.identifier.citation | Neurogastroenterology and Motility, 2015, v. 27, n. 8, p. 1183-1189 | - |
dc.identifier.issn | 1350-1925 | - |
dc.identifier.uri | http://hdl.handle.net/10722/301792 | - |
dc.description.abstract | Background: Pharyngeal automated impedance manometry (AIM) analysis is a novel non-radiological method to analyze swallowing function based on impedance-pressure recordings. In dysphagic head and neck cancer patients, we evaluated the reliability and validity of the AIM-derived swallow risk index (SRI) and a novel measure of postswallow residue (iZn/Z) by comparing it against videofluoroscopy as the gold standard. Methods: Three blinded experts classified 88 videofluoroscopic swallows from 16 patients for aspiration and degree of postswallow residue. Pressure-impedance recordings of the patient and age-matched control swallows were analyzed using AIM by three observers who derived the SRI and iZn/Z. Intra-class correlation coefficients (ICC) were calculated for videofluoroscopic and AIM measures. Patient pressure/impedance measurements were compared with videofluoroscopy scores and control subjects to determine validity for detecting clinically relevant swallowing dysfunction. Key Results: Agreement among observers assessing presence of penetration and aspiration was modest (ICC 0.57) for videofluoroscopy and good (ICC 0.71, 0.82) for AIM-derived SRI and iZn/Z. When compared with age-matched controls, the SRI was higher in patients with aspiration (mean diff. 28.6, 95% CI [55.85, 1.355], p < 0.05). The iZn/Z had moderate positive correlation with bolus residue on fluoroscopy (BRS score) (rs(86) = 0.4120, p < 0.0001) and was increased in both patients with aspiration ({increment}244 [419.7, 69.52; p < 0.05]) and penetration ({increment}240 [394.3, 85.77]; p < 0.05) compared to controls. Conclusions & Inferences: AIM-based measures of swallowing function have better inter-rater reliability than comparable fluoroscopically derived measures. These measures are easily determined and objective markers of clinically relevant features of disordered swallowing following radiotherapy. | - |
dc.language | eng | - |
dc.relation.ispartof | Neurogastroenterology and Motility | - |
dc.subject | Videofluoroscopy | - |
dc.subject | Impedance | - |
dc.subject | Manometry | - |
dc.subject | Reliability | - |
dc.subject | Dysphagia | - |
dc.subject | Pharynx | - |
dc.title | Inter-rater reliability and validity of automated impedance manometry analysis and fluoroscopy in dysphagic patients after head and neck cancer radiotherapy | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1111/nmo.12610 | - |
dc.identifier.pmid | 26031361 | - |
dc.identifier.scopus | eid_2-s2.0-84937971681 | - |
dc.identifier.volume | 27 | - |
dc.identifier.issue | 8 | - |
dc.identifier.spage | 1183 | - |
dc.identifier.epage | 1189 | - |
dc.identifier.eissn | 1365-2982 | - |
dc.identifier.isi | WOS:000364747100017 | - |