title: Inter- and intrajudge reliability of a clinical examination of swallowing in adults.
abstract: This study investigates inter- and intrajudge reliability of a clinical examination of swallowing in adults. Several investigations have sought correlations between clinical indicators of dysphagia and the actual presence of dysphagia as determined by videofluoroscopy. Whereas some investigations have reported interjudge reliability for the videofluoroscopic measures employed, none have reported reliability for clinical measures. Without established reliability for rating clinical measures, conclusions drawn regarding the utility of a measure for detecting aspiration can be called into question. Results of the present study indicate that fewer than 50% of the measures clinicians typically employ are rated with sufficient inter- and intrajudge reliability. Measures of vocal quality and oral motor function were rated more reliably than were history measures or measures taken during trial swallows. There is a need to define more clearly the measures employed in clinical examinations and to be consistent in reporting reliability for clinical measures of swallowing function in future research.
authors.affiliation: Department of Audiology and Speech Pathology, University of Tennessee, Knoxville, TN 37996, USA. gmccullo@utk.edu
authors.forename: G H
authors.initials: GH
authors.lastname: McCullough
authors.forename: R T
authors.initials: RT
authors.lastname: Wertz
authors.forename: J C
authors.initials: JC
authors.lastname: Rosenbek
authors.forename: R H
authors.initials: RH
authors.lastname: Mills
authors.forename: K B
authors.initials: KB
authors.lastname: Ross
authors.forename: J R
authors.initials: JR
authors.lastname: Ashford
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002933:Cineradiography; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008334:Mandible / Q000503:physiopathology; D008487:Medical History Taking; D008875:Middle Aged; D009055:Mouth / Q000503:physiopathology; D015588:Observer Variation; D010808:Physical Examination; D015203:Reproducibility of Results; D013223:Statistics as Topic; D020521:Stroke / Q000150:complications; D014059:Tongue / Q000503:physiopathology; D014741:Video Recording; D014833:Voice Quality / Q000502:physiology