title: [Secretion scale by Murray et al. for FEES®: comparison of reliability and validity of the German long and short version].
abstract: BACKGROUND
  Accumulation of secretions in the hypopharynx, aditus laryngis and trachea constitute a cardinal trait of oropharyngeal dysphagia. For the evaluation of the degree of severity a 4-point secretion scale by Murray et al. is used internationally in a long and a short version. However, a validated German translation of the long version of this scale does not yet exist. Also, it has not yet been scientifically proven that both versions of the scale are equally valid.
  
  
  OBJECTIVE
  This study aimed at the validation of the German translation of the long version of the secretion scale by Murray et al. and at a comparison of reliability and validity of the short and long versions.
  
  
  METHODS
  A total of 40 videos of fiberoptic endoscopic evaluation of swallowing (FEES(®)), 10 for each severity level, were rated by 4 otorhinolaryngologists (ENT specialists) independently and with different randomizations for examination of the reliability and validity. Two rating sessions for each of the scale versions were conducted. Intrarater and interrater reliability as well as the agreement of the ratings with a reference standard were analyzed.
  
  
  RESULTS
  Both the intrarater reliability (Spearman correlations: ρs > 0.840***) and the interrater reliability (Krippendorff's alpha: α > 0.850) yielded very good results and the concurrent validity was highly significant (ρs > 0.981***).
  
  
  CONCLUSIONS
  The German translation of the secretion scale by Murray et al. can be considered reliable and valid, with comparable test accuracy of the short and long versions. Hence, the scale can be recommend for the graduation of pharyngolaryngotracheal secretions and should be integrated into the standardized evaluation of FEES(®) diagnostics for clinical and scientific purposes.
authors.affiliation: Schwerpunkt für Phoniatrie und Pädaudiologie, Klinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, Haus 7A, 60590, Frankfurt am Main, Deutschland, petra.pluschinski@kgu.de.
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: J-C
authors.initials: JC
authors.lastname: Koseki
authors.forename: M
authors.initials: M
authors.lastname: Leinung
authors.forename: L
authors.initials: L
authors.lastname: Girth
authors.forename: J
authors.initials: J
authors.lastname: Wagenblast
authors.forename: R
authors.initials: R
authors.lastname: Sader
authors.forename: T
authors.initials: T
authors.lastname: Stöver
authors.forename: C
authors.initials: C
authors.lastname: Hey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000175:diagnosis*; 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; D011795:Surveys and Questionnaires; D014175:Translating