دورية أكاديمية
أعرض في EDS

Reliability and validity of cervical auscultation: a controlled comparison using videofluoroscopy.

التفاصيل البيبلوغرافية
العنوان: Reliability and validity of cervical auscultation: a controlled comparison using videofluoroscopy.
المؤلفون: Leslie P; School of Surgical and Reproductive Sciences, The Medical School, University of Newcastle, Newcastle-upon-Tyne, United Kingdom. Paula.Leslie@newcastle.ac.uk, Drinnan MJ, Finn P, Ford GA, Wilson JA
المصدر: Dysphagia [Dysphagia] 2004 Fall; Vol. 19 (4), pp. 231-40.
نوع المنشور: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Study
اللغة: English
بيانات الدورية: Publisher: Springer-Verlag Country of Publication: United States NLM ID: 8610856 Publication Model: Print Cited Medium: Print ISSN: 0179-051X (Print) Linking ISSN: 0179051X NLM ISO Abbreviation: Dysphagia Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York : Springer-Verlag, [c1986-
مواضيع طبية MeSH: Auscultation/*methods , Deglutition/*physiology , Deglutition Disorders/*diagnosis , Pharynx/*physiology , Stroke/*complications, Aged ; Aged, 80 and over ; Case-Control Studies ; Deglutition Disorders/diagnostic imaging ; Deglutition Disorders/etiology ; Humans ; Observer Variation ; Pharynx/diagnostic imaging ; Photofluorography ; Reproducibility of Results ; Respiratory Sounds ; Stroke/physiopathology ; Video Recording
مستخلص: Cervical auscultation is experiencing a renaissance as an adjunct to the clinical swallowing assessment. It is a controversial technique with a small evidence base. We have aimed to establish whether cervical auscultation interpretation is based on the actual sounds heard or, in practice, influenced by information gleaned from other aspects of the clinical assessment, medical notes, or previous knowledge. We sought to determine (a) rater reliability and its impact on the clinical value of cervical auscultation and (b) how judgments compare with the "gold standard": videofluoroscopy. Swallow sounds were computer recorded via a Littmann stethoscope. Sounds were sampled from 10 healthy control swallows with no aspiration/penetration and 10 patient swallows with aspiration/penetration, all recorded during simultaneous videofluoroscopy. The system generated sound quality similar to "live" bedside listening, a feature rarely seen in cervical auscultation studies. The 20 sound clips were classified as "normal" or "abnormal" by 19 volunteer speech-language pathologists with experience in cervical auscultation. After at least four weeks, 11 of these judges rated the sounds rerandomized on a new CD. Intrarater reliability kappa ranged from -0.12 to 0.71. Individual reliability did not correlate with years of experience, practice pattern, or frequency of use. Interrater reliability kappa = 0.17. Comparison with radiologically defined aspiration/penetration yielded 66% specificity, 62% sensitivity, and majority consensus gave 90% specificity, 80% sensitivity. There was a significant relationship between individual reliability and true positive rate (r(s) = 0.623, p = 0.040). The reliability of individual judges varied widely and thus, inevitably, agreement between judges was poor. Validity is dependent upon reliability: Improving the poor raters would improve the overall accuracy of this technique in predicting abnormality in swallowing. The group consensus correctly identified 17 of the 20 clips so we may speculate that the swallow sound contains audible cues that should in principle permit reliable classification.
References: Dysphagia. 2002 Summer;17(3):208-13. (PMID: 12140647)
Clin Rehabil. 2002 Sep;16(6):640-5. (PMID: 12392339)
Dysphagia. 1998 Summer;13(3):142-7. (PMID: 9633153)
Dysphagia. 1994 Winter;9(1):63-8. (PMID: 8131427)
Dysphagia. 1993;8(3):170-9. (PMID: 8359036)
Dysphagia. 2000 Spring;15(2):58-67. (PMID: 10758187)
Dysphagia. 1994 Winter;9(1):54-62. (PMID: 8131426)
Dysphagia. 2002 Spring;17(2):139-46. (PMID: 11956839)
Lancet. 1991 Jun 22;337(8756):1521-6. (PMID: 1675378)
J Speech Hear Res. 1996 Feb;39(1):144-52. (PMID: 8820706)
Dysphagia. 2001 Summer;16(3):208-15. (PMID: 11453569)
BMJ. 2003 Feb 22;326(7386):433-6. (PMID: 12595385)
AJR Am J Roentgenol. 2003 Jun;180(6):1613-6. (PMID: 12760930)
Dysphagia. 1998 Spring;13(2):69-81. (PMID: 9513300)
Ann Otol Rhinol Laryngol. 2002 Jul;111(7 Pt 1):623-32. (PMID: 12126019)
Dysphagia. 1998 Fall;13(4):223-7. (PMID: 9716754)
Dysphagia. 1995 Winter;10(1):27-31. (PMID: 7859529)
Biometrics. 1977 Mar;33(1):159-74. (PMID: 843571)
Dysphagia. 2001 Spring;16(2):110-8. (PMID: 11305220)
Dysphagia. 2000 Winter;15(1):19-30. (PMID: 10594255)
J Neurol Neurosurg Psychiatry. 1997 Oct;63(4):456-60. (PMID: 9343123)
تواريخ الأحداث: Date Created: 20050126 Date Completed: 20050323 Latest Revision: 20191210
رمز التحديث: 20231215
PMID: 15667057
قاعدة البيانات: MEDLINE
الوصف
تدمد:0179-051X