Inter- and intrajudge reliability for videofluoroscopic swallowing evaluation measures
Inter- and intrajudge reliability for videofluoroscopic swallowing evaluation measures
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DOI：
10.1007/pl00021291
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发表时间：
2001-03-01
期刊：
影响因子：
2.6
通讯作者：
Ross, KB
中科院分区：
文献类型：
--
作者：
McCullough, GH;Wertz, RT;Ross, KB
对视频荧光透视（VFS）吞咽评估的判断间可靠性进行了研究，结果表明，在大多数情况下，可靠性较差。虽然以前的研究是精心设计的调查interjudge的可靠性，很少有报告的interjudge的可靠性是来自临床医生通常采用的逐帧分析的VFS措施。本研究的目的是检查之间和法官内的可靠性VFS检查措施，通常用于评估吞咽功能。未进行标准培训。对20名在6周内中风且无结构异常或气管造口术的患者进行了VFS检查。三名临床法官作为受试者，并从录像带使用逐帧分析的VFS检查。临床医生对20项检查中采用的措施进行了反复审查，结果表明许多措施具有较高的判断内可靠性，这表明经验丰富的临床医生可以采用一致的标准对患者和时间的某些VFS措施进行评级。这些标准似乎在临床医生之间存在差异，并产生不可接受的相互判断的可靠性。需要培训临床医生的标准，以提高判断的可靠性进行了讨论。
Interjudge reliability for videofluoroscopic (VFS) swallowing evaluations has been investigated, and results have, for the most part, indicated that reliability is poor. While previous studies are well-designed investigations of interjudge reliability, few reports of intrajudge reliability are available for VFS measures derived from frame-by-frame analysis that clinicians typically employ. The purpose of this study was to examine the inter- and intrajudge reliability of VFS examination measures commonly used to assess swallowing functions. No training to criteria occurred. VFS examinations were conducted on 20 patients who had suffered a stroke within six weeks and had no structural abnormalities or tracheostomies. Three clinical judges served as subjects and rated the VFS examinations from videotape using frame-by-frame analysis. A clinician's repeated re-view of measures employed in the 20 examinations indicated high intrajudge reliability for a number of measures, suggesting that an experienced clinician may employ consistent standards for rating certain VFS measures across patients and time. These standards appear to vary among clinicians and yield unacceptable interjudge reliability. The need to train clinicians to criteria to improve interjudge reliability is discussed.