Scoring the Penetration-Aspiration Scale (PAS) in Two Conditions: A Reliability Study.
Munirah Alkhuwaiter, Kate Davidson, Theresa Hopkins-Rossabi and 1 others
PMID 33880656WHAT IT FOUND
Scoring swallowing videos as whole studies or as isolated random swallows showed no significant difference in how consistently raters scored airway invasion severity.
This pilot was small, so clinicians should not assume either method is proven.
Key findings
01The study compared 15 swallowing recordings and 126 isolated swallow tasks scored by 11 raters.
02For student raters, isolated-swallow scoring showed numerically higher agreement and accuracy than whole-study scoring, but the differences were not statistically significant.
03For clinician raters, the differences between whole-study and isolated-swallow scoring were not statistically significant.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was a pilot with only 15 swallowing recordings and 11 raters, so it gives limited certainty about whether the methods are equally reliable. Student raters had no prior PAS scoring experience, and only 4 certified speech-language pathologists served as clinician raters. Fourteen student-rater tasks were omitted because two raters reported scoring uncertainty, while clinician raters completed all 252 tasks. The sample was not statistically balanced across PAS scores because severe patients often did not complete the full protocol. The study measured rater agreement and accuracy, not patient swallowing outcomes or treatment decisions. The reference standard was consensus scoring by 2 experienced speech-language pathologists.
Declared interests
The supplied article text does not include a conflict or funding declaration; the journal metadata lists NIH extramural research support.
The easy way to misread this
Do not conclude that the two PAS scoring methods are proven equivalent. This was a small pilot, and the study showed no statistically significant difference, not that the methods performed identically.