Quantifying Pharyngeal Residue during Videofluoroscopic Swallow Studies (VFSS/MBS): Validation of Percentage-Based Visual-Perceptual Residue Ratings.
James Curtis, Valentina Mocchetti, Brandon Jagdhar and 3 others
PMID 40795820WHAT IT FOUND
Percentage-based visual ratings of pharyngeal residue on VFSS still images matched pixel-based ground truth with moderate-to-substantial agreement and excellent reliability.
Accuracy was higher for clinicians using frame-by-frame analysis and standardized tools, but lower with more years of experience.
Key findings
01Visual-perceptual percentage ratings of bolus clearance ratio and vallecular residue showed moderate-to-substantial agreement with ground-truth pixel measurements, with median absolute differences of 7.41 and 6.47 percentage points respectively.
02Group-level inter-rater reliability was good-to-excellent (ICC 0.90-0.93) and intra-rater reliability was excellent (ICC 0.92-0.97) for both measures.
03Greater years of work experience were associated with lower rating accuracy, while frequent use of frame-by-frame analysis and standardized assessments like DIGEST or MBSImP were associated with greater accuracy.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study used static images with superimposed digital tracings to guide ratings, which does not reflect typical clinical practice where such visual aids are absent. The design was survey-based, potentially introducing sampling bias toward clinicians with more time or motivation. The study did not assess dynamic swallowing events, bolus timing, or kinematic measures. Piriform residue ratings were not examined. The study did not directly compare the interpretability of percentage-based versus categorical ratings in real-world clinical communication.
Declared interests
The authors declared no conflicts of interest. The study was not supported by any funder.
The easy way to misread this
Do not assume this accuracy applies to standard clinical VFSS interpretation without visual aids. The high accuracy and reliability observed depended on clinicians using still images with superimposed digital tracings that defined the exact spatial boundaries for rating. Real-world clinical practice lacks these explicit boundaries, which may reduce precision.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →