TY - JOUR
T1 - Multicenter Interrater Reliability in the Endoscopic Assessment of Velopharyngeal Function Using a Video Instruction Tool
AU - Miller, Craig
AU - Bly, Randall
AU - Cofer, Shelagh
AU - Dahl, John P.
AU - de Serres, Lianne
AU - Goudy, Steven
AU - Hartzell, Larry
AU - Jabbour, Noel
AU - Kacmarysnki, Deborah
AU - Macarthur, Carol
AU - Messner, Anna
AU - Milczuk, Henry
AU - Rastatter, Jeff
AU - Swibel Rosenthal, Laura H.
AU - Scott, Andrew
AU - Tollefson, Travis
AU - Woolley, Audie
AU - Zdanski, Carlton
AU - Zopf, Dave A.
AU - Sie, Kathleen
N1 - Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2019.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Objective: Assess interrater agreement of endoscopic assessment of velopharyngeal (VP) function before and after viewing the video instruction tool (VIT). We hypothesized improvement in interrater agreement using the Golding-Kushner scale (GKS) after viewing the VIT. Study Design: Prospective study. Setting: Multi-institutional. Methods: Sixteen fellowship-trained pediatric otolaryngologists who treat velopharyngeal insufficiency (VPI) rated 50 video segments using the GKS before and after watching the VIT. Raters assessed gap size percentage and lateral pharyngeal wall (LPW), soft palate (SP), and posterior pharyngeal wall (PPW) movement. Intraclass correlation coefficient was estimated for these continuous measures. Raters also indicated the presence of a palatal notch, Passavant’s ridge, and aberrant pulsations (categorical variables). Fleiss κ coefficient was used for categorical variables. Wilcoxon signed-rank test was performed on the difference between the pre/post individual video ratings. Results: Reliability improved for all continuous variables after watching the instructional video. The improvement was significant for PPW (0.22-0.30, P <.001), SP (left: 0.63-0.68, P <.001 and right: 0.64-0.68, P =.001), and LPW (left: 0.49-0.54, P =.01 and right: 0.49-0.54, P =.09) but not significant for gap size (0.65-0.69, P =.36). Among categorical variables, agreement on Passavant’s ridge significantly improved (0.30-0.36, P =.03). Conclusion: Exposure to a video instruction tool improves interrater agreement of endoscopic assessment of VP function. Significant improvement was observed in our primary end points, specifically posterior pharyngeal wall movement, soft palate movement, and lateral pharyngeal wall movement. There was less impact of the VIT on the interrater agreement of the categorical variables, palatal notch, Passavant’s ridge, and aberrant pulsations.
AB - Objective: Assess interrater agreement of endoscopic assessment of velopharyngeal (VP) function before and after viewing the video instruction tool (VIT). We hypothesized improvement in interrater agreement using the Golding-Kushner scale (GKS) after viewing the VIT. Study Design: Prospective study. Setting: Multi-institutional. Methods: Sixteen fellowship-trained pediatric otolaryngologists who treat velopharyngeal insufficiency (VPI) rated 50 video segments using the GKS before and after watching the VIT. Raters assessed gap size percentage and lateral pharyngeal wall (LPW), soft palate (SP), and posterior pharyngeal wall (PPW) movement. Intraclass correlation coefficient was estimated for these continuous measures. Raters also indicated the presence of a palatal notch, Passavant’s ridge, and aberrant pulsations (categorical variables). Fleiss κ coefficient was used for categorical variables. Wilcoxon signed-rank test was performed on the difference between the pre/post individual video ratings. Results: Reliability improved for all continuous variables after watching the instructional video. The improvement was significant for PPW (0.22-0.30, P <.001), SP (left: 0.63-0.68, P <.001 and right: 0.64-0.68, P =.001), and LPW (left: 0.49-0.54, P =.01 and right: 0.49-0.54, P =.09) but not significant for gap size (0.65-0.69, P =.36). Among categorical variables, agreement on Passavant’s ridge significantly improved (0.30-0.36, P =.03). Conclusion: Exposure to a video instruction tool improves interrater agreement of endoscopic assessment of VP function. Significant improvement was observed in our primary end points, specifically posterior pharyngeal wall movement, soft palate movement, and lateral pharyngeal wall movement. There was less impact of the VIT on the interrater agreement of the categorical variables, palatal notch, Passavant’s ridge, and aberrant pulsations.
KW - VPI
KW - interrater reliability
KW - velopharyngeal insufficiency
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U2 - 10.1177/0194599818822989
DO - 10.1177/0194599818822989
M3 - Article
C2 - 30642231
AN - SCOPUS:85060922359
SN - 0194-5998
VL - 160
SP - 720
EP - 728
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 4
ER -