title: The Boston Residue and Clearance Scale: preliminary reliability and validity testing.
abstract: BACKGROUND
  There is no appropriately validated scale with which to rate the problem of residue after swallowing. The Boston Residue and Clearance Scale (BRACS) was developed to meet this need. Initial reliability and validity were assessed.
  
  
  METHODS
  BRACS is an 11-point ordinal residue rating scale scoring three aspects of residue during a fiberoptic endoscopic evaluation of swallowing (FEES): (1) the amount and location of residue, (2) the presence of spontaneous clearing swallows, and (3) the effectiveness of clearing swallows. To determine inter-rater and test-retest reliability, 63 swallows from previously recorded FEES procedures were scored twice by 4 raters using (1) clinical judgment (none, mild, mild-moderate, moderate, moderate-severe, severe) and (2) BRACS. Concurrent validity was tested by correlating clinical judgment scores with BRACS scores. Internal consistency of the items in BRACS was examined. A factor analysis was performed to identify important factors that suggest grouping within the 12 location items in BRACS.
  
  
  RESULTS
  BRACS showed excellent inter-rater reliability (intraclass correlation coefficient, ICC = 0.81), test-retest reliability (ICC: 0.82-0.92), high concurrent validity (Pearson's r = 0.76), and high internal consistency (Cronbach's α = 0.86). Factor analysis revealed 3 main latent factors for the 12 location items.
  
  
  CONCLUSIONS
  BRACS is a valid and reliable tool that can rate the severity of residue.
authors.affiliation: Department of Speech Language Hearing Sciences, Sargent College, Boston University, Boston, Mass., USA.
authors.forename: Asako S
authors.initials: AS
authors.lastname: Kaneoka
authors.forename: Susan E
authors.initials: SE
authors.lastname: Langmore
authors.forename: Gintas P
authors.initials: GP
authors.lastname: Krisciunas
authors.forename: Katherine
authors.initials: K
authors.lastname: Field
authors.forename: Rebecca
authors.initials: R
authors.lastname: Scheel
authors.forename: Edel
authors.initials: E
authors.lastname: McNally
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Walsh
authors.forename: Meredith B
authors.initials: MB
authors.lastname: O'Dea
authors.forename: Howard
authors.initials: H
authors.lastname: Cabral
mesh_terms: D000368:Aged; D003680:Deglutition Disorders / Q000175:diagnosis*; D004945:Esophagoscopy; D005260:Female; D005336:Fiber Optic Technology; D017144:Focus Groups; D005502:Food; D005766:Gastrointestinal Contents; D006801:Humans; D007013:Hypopharynx / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014741:Video Recording