title: [Penetration-Aspiration Scale according to Rosenbek. Validation of the German version for endoscopic dysphagia diagnostics].
abstract: BACKGROUND
  The Penetration-Aspiration Scale was developed by Rosenbek et al. to enable standardized documentation of this cardinal symptom of a swallowing disorder.
  
  
  OBJECTIVE
  The objective was to create and validate a German version of the Penetration-Aspiration Scale according to the guidelines governing the translation of foreign language measurement tools.
  
  
  METHODS
  Both reliability and validity were examined based on the ratings of 80 randomized endoscopically evaluated swallows, 10 for each severity level. Ratings were carried out by four independent raters: two with more than 3 years' experience with dysphagia and a further two with less than 3 years' experience. The swallows were rerated after 4 weeks.
  
  
  RESULTS
  Both intrarater (Kendall's Tau: τs > 0.643; median 0.773; ps < 0.001) and interrater reliability were highly significant (two-way mixed single ICC coefficient of 0.799 for the first rating session and 0.728 for the second session; ps < 0.001). Results from the raters with less than 3 years' experience were significantly different from the reference standard in three out of four cases, whereas this was not the case for the more experienced raters. However, for each film, the median of the individual ratings from all four raters correlated almost perfectly with the reference standard (first rating session: τ = 0.894; second rating session: τ = 0.843; ps < 0.001).
  
  
  CONCLUSIONS
  The German version of the Penetration-Aspiration Scale according to Rosenbek presented here was demonstrated to be both reliable and valid. Despite its dependency on the raters' experience, it can therefore be used as a graduation instrument for swallowing disorders in German-speaking countries and make an important contribution to evidence-based medicine in dysphagiology for both clinical and scientific use.
authors.affiliation: Schwerpunkt für Phoniatrie und Pädaudiologie, Klinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Frankfurt am Main, Goethe-Universität, Theodor-Stern-Kai 7, Haus 7A, 60590, Frankfurt am Main, Deutschland, christiane.hey@kgu.de.
authors.forename: C
authors.initials: C
authors.lastname: Hey
authors.forename: P
authors.initials: P
authors.lastname: Pluschinski
authors.forename: Y
authors.initials: Y
authors.lastname: Zaretsky
authors.forename: A
authors.initials: A
authors.lastname: Almahameed
authors.forename: D
authors.initials: D
authors.lastname: Hirth
authors.forename: B
authors.initials: B
authors.lastname: Vaerst
authors.forename: J
authors.initials: J
authors.lastname: Wagenblast
authors.forename: T
authors.initials: T
authors.lastname: Stöver
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D003680:Deglutition Disorders / Q000145:classification* / Q000473:pathology*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D064232:Visual Analog Scale