title: [Validation of the German short version of the Murray Secretion Rating Scale].
abstract: OBJECTIVE
  Accumulation of secretions in hypopharynx, aditus vestibule, and trachea is often found in cases of severe dysphagia and is considered a cardinal trait of high clinical and therapeutic importance. For the graduation of the severity level of accumulated secretions, a short version of the 4-point Murray secretion scale is available, which is also integrated into the protocol of the fiberoptic endoscopic evaluation of swallowing (FEES) according to the Langmore standard. This study aimed at the validation of the German translation of this short version in order to facilitate a uniform, standardized evaluation of the accumulation of secretions in dysphagic patients in the German language area.
  
  
  METHODS
  For the examination of reliability and validity, a reference standard was defined by 2 dysphagia experts on the basis of 40 video files of the FEES examination, 10 videos for each of the severity grades. Afterwards, these videos were rated independently by 4 raters and re-rated in a new randomized order 2 weeks later.
  
  
  RESULTS
  Both the intra-rater reliability (τ>0,830***) and the inter-rater reliability (Kendalls W>0,890***) were highly significant and can be considered good. The same is valid for the correlation of ratings with the reference standard (τ=0,969***).
  
  
  CONCLUSIONS
  The German translation of the short version of the 4-point Murray secretion scale is recommendable as a reliable and valid instrument for the graduation of the cardinal trait of oropharyngeal dysphagia and also as an evidence-based instrument for standardized use in the German language area.
authors.affiliation: Schwerpunkt für Phoniatrie und Pädaudiologie, Klinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Frankfurt am Main.
authors.forename: C
authors.initials: C
authors.lastname: Hey
authors.affiliation: Schwerpunkt für Phoniatrie und Pädaudiologie, Klinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Frankfurt am Main.
authors.forename: P
authors.initials: P
authors.lastname: Pluschinski
authors.affiliation: Klinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Frankfurt am Main.
authors.forename: T
authors.initials: T
authors.lastname: Stöver
authors.affiliation: Schwerpunkt für Phoniatrie und Pädaudiologie, Klinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Frankfurt am Main.
authors.forename: Y
authors.initials: Y
authors.lastname: Zaretsky
mesh_terms: D003431:Cross-Cultural Comparison; D003680:Deglutition Disorders / Q000145:classification* / Q000175:diagnosis / Q000503:physiopathology*; D004282:Documentation / Q000145:classification / Q000379:methods; D004724:Endoscopy; D006801:Humans; D007013:Hypopharynx / Q000378:metabolism*; D007820:Laryngeal Mucosa / Q000378:metabolism*; D015588:Observer Variation; D056144:Pyriform Sinus / Q000378:metabolism*; D011897:Random Allocation; D012016:Reference Values; D015203:Reproducibility of Results; D014132:Trachea / Q000378:metabolism*; D014175:Translating; D014741:Video Recording