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KMID : 1024320220120010059
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Journal of the Korean Dysphagia Society
2022 Volume.12 No. 1 p.59 ~ p.63
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Standardization of FEES Evaluation for the Accurate Diagnosis of Dysphagia
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Kim Bo-Young
Lee Jin
Kim Bo-Hae
Park Hanaro
Park Sung-Joon
Song Chang-Myeon
Chung Eun-Jae
Kwon Tack-Kyun
Jin Young-Ju
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Abstract
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Objective: Fiberoptic endoscopic evaluation of swallowing (FEES) is a standard diagnostic tool for swallowing disorders. However, it has not been used frequently in Korea because of the long test time, low cost, and the absence of a standard evaluation system. The purpose of this study was to suggest a standard fill-out form for the FEES result.
Methods: From February 2019 to June 2020, a total of 98 FEES tests were performed by an otolaryngologist (JYJ) at the Wonkwang University Hospital. After the exclusion of 68 cases, 30 cases were analyzed twice by 4 raters with over 5 years of experience as otolaryngologists working in various hospitals. The results were measured for the rater’s test-retest reliability and inter-rater consistency.
Results: Cohen’s kappa values for measuring the intra-rater consistency of the four raters were 0.984, 0.887, 0.848, and 0.930, respectively, meaning very good alignment of 0.8 or more, respectively. The Fleiss Kappa value for measuring inter-rater consistency was 0.276, meaning ‘fair’ for values of 0.2 or more. To examine consistency, an intraclass correlation coefficient (ICC) analysis conducted by assuming the grading score to be a constant continuous variable gave an ICC value of 0.729 (P＜0.001), showing a very reliable tendency.
Conclusion: In this study, all the items of the fill-out form were rated using a three-step grading scale, so the degree of agreement was high when performed twice by the same rater, but the degree of agreement among raters was relatively low. Therefore, our fill-out form for FEES will be useful in evaluating the improvement of a patient over the course of clinical treatment.
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KEYWORD
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Fiberoptic endoscopic evaluation of swallowing, Swallowing disorder, Fill out form
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