title: Bolus Residue Scale: An Easy-to-Use and Reliable Videofluoroscopic Analysis Tool to Score Bolus Residue in Patients with Dysphagia.
abstract: Background. We aimed to validate an easy-to-use videofluoroscopic analysis tool, the bolus residue scale (BRS), for detection and classification of pharyngeal retention in the valleculae, piriform sinuses, and/or the posterior pharyngeal wall. Methods. 50 randomly selected videofluoroscopic images of 10 mL swallows (recorded in 18 dysphagia patients and 8 controls) were analyzed by 4 experts and 6 nonexpert observers. A score from 1 to 6 was assigned according to the number of structures affected by residue. Inter- and intrarater reliabilities were assessed by calculation of intraclass correlation coefficients (ICCs) for expert and nonexpert observers. Sensitivity, specificity, and interrater agreement were analyzed for different BRS levels. Results. Intrarater reproducibility was almost perfect for experts (mean ICC 0.972) and ranged from substantial to almost perfect for nonexperts (mean ICC 0.835). Interjudge agreement of the experts ranged from substantial to almost perfect (mean ICC 0.780), but interrater reliability of nonexperts ranged from substantial to good (mean 0.719). BRS shows for experts a high specificity and sensitivity and for nonexperts a low sensitivity and high specificity. Conclusions. The BRS is a simple, easy-to-carry-out, and accessible rating scale to locate pharyngeal retention on videofluoroscopic images with a good specificity and reproducibility for observers of different expertise levels.
authors.affiliation: Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium ; Gastroenterology, Neurogastroenterology and Motility, University Hospitals Leuven, 3000 Leuven, Belgium ; Translational Research Center for Gastrointestinal Diseases (TARGID), KU Leuven, 3000 Leuven, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rommel
authors.affiliation: Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Borgers
authors.affiliation: Radiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Van Beckevoort
authors.affiliation: Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium ; ENT, Head & Neck Surgery, MUCLA, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: Goeleven
authors.affiliation: Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Eddy
authors.initials: E
authors.lastname: Dejaeger
authors.affiliation: Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium ; School of Medicine, Flinders University, Bedford Park, Australia ; The Robinson Research Institute, University of Adelaide, Adelaide, Australia.
authors.forename: Taher I
authors.initials: TI
authors.lastname: Omari