Reliability and Confidence of Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) Rating Among Research and Clinical Speech Pathologists Before and After Implementation of a Training Manual: A Multi-site Study.
C E A Barbon, C L Warneke, B Ledger and 7 others
PMID 39181934WHAT IT FOUND
After a written training manual for DIGEST, a swallowing grading method, 23 speech pathologists' video ratings matched the lab standard a median 84% of the time, compared with a median 76% among 32 raters at baseline.
Confidence rose, but confidence did not track accuracy.
Key findings
01At baseline, 32 speech-language pathologists' overall DIGEST grades matched the laboratory rating a median 76% of the time.
02After the manual, the 23 raters who completed all rounds matched the laboratory rating a median 84% of the time, with individual agreement ranging from 68% to 95%.
03High confidence rose from 9/23 raters before training to 22/23 after training, but the association between confidence and reliability was not statistically significant.
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 was not randomized, so the change from round 1 to round 3 cannot be attributed only to the training manual; repeated viewing or other factors may explain it. Only 23 of 32 raters completed all rounds and the survey, so the post-training and survey results reflect a subset. Raters were a convenience sample from collaborating institutions and included students, postdoctoral fellows, and clinicians, so they may not represent all speech pathologists using DIGEST. There was no later round to check whether the improved agreement lasted after training. The study was done virtually, so playback software and image quality varied between raters. Post-training confidence was not statistically associated with post-training reliability, so confidence alone does not show better grading.
Declared interests
The supplied text does not include a conflicts-of-interest declaration. It states that the DIGEST training manual was developed by the tool originators at MD Anderson for work related to R01CA271223, and expert DIGEST users served as benchmark raters.
The easy way to misread this
Do not conclude that the written manual alone caused better DIGEST grading. The study was not randomized, so the improvement from round 1 to round 3 could also reflect repeated viewing or other factors.