Pharyngeal Residue Scoring in Fiberoptic Endoscopic Evaluation of Swallowing: Reliability Comparison and Applicability Among Different Scales.
Federica Messina, Sara Rocca, Beatrice Manca and 4 others
PMID 38329538WHAT IT FOUND
The Yale scale was the most reliable for scoring pharyngeal residue on FEES.
The Boston scale was significantly slower and harder to use. The RORS was the easiest. Choose the Yale scale for a balance of accuracy and speed in routine practice.
Key findings
01The Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) demonstrated excellent inter-rater reliability, which was significantly higher than the other three scales tested.
02The Boston Residue and Clearance Scale (BRACS) took significantly longer to score and was perceived as significantly more difficult than the other scales.
03The Residue Ordinal Rating Scale (RORS) was perceived as significantly easier to score than the other scales.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only four raters participated, and they all had relatively little experience (0 to 5 years). The sample size was small (25 videos), and no power calculation was performed. The study did not analyze whether years of experience or the specific neurological diagnosis affected the scoring. The time taken to score was self-reported by the raters. The videos were recorded with blue-dyed water, which may affect how residue is visualized compared to other dyes.
Declared interests
None reported.
The easy way to misread this
Do not assume the YPRSRS is the only viable option. While it had the highest inter-rater reliability, the other scales still showed substantial agreement, and the RORS was significantly easier and faster to use, which may be preferable in time-pressured settings.