Validation of the European Portuguese Version of the Yale Pharyngeal Severity Rating Scale.
Isabel Silva-Carvalho, Adriana Martins, Susana Vaz Freitas and 3 others
PMID 39060512WHAT IT FOUND
The European Portuguese Yale Pharyngeal Severity Rating Scale shows excellent agreement when the same expert rates the same images twice.
Agreement between different raters is moderate overall but high among those with experience using the scale. New users need training before relying on it.
Key findings
01Intra-rater reliability was excellent for both vallecula and pyriform sinus, with average ICC values of 0.974 and 0.958 respectively.
02Inter-rater agreement was moderate overall, with kappa values of 0.613 for vallecula and 0.588 for pyriform sinus.
03Raters with prior experience using the scale achieved high agreement, with kappa values of 0.832 for vallecula and 0.856 for pyriform sinus.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study used static images rather than full video sequences, which may not reflect the complexity of real-time clinical assessment. Most raters (11 of 13) had no prior experience with the scale, and many were residents, which may have depressed overall inter-rater agreement figures. There was no independent gold standard for comparison; construct validity relied on expert consensus ratings. The sample of raters was small and predominantly medical (12 otolaryngologists), with only one speech-language pathologist.
Declared interests
The study was funded by Unidade Local de Saúde de Santo António. No other conflicts of interest were declared.
The easy way to misread this
Do not assume the scale is equally reliable for all clinicians. The high agreement seen in the study was driven by experienced users. New raters should expect moderate agreement with peers and seek specific training before using the scale for critical clinical decisions or research.