TY - JOUR
T1 - Scoring the Penetration–Aspiration Scale (PAS) in Two Conditions
T2 - A Reliability Study
AU - Alkhuwaiter, Munirah
AU - Davidson, Kate
AU - Hopkins-Rossabi, Theresa
AU - Martin-Harris, Bonnie
N1 - Funding Information:
This study was supported by the National Institute on Deafness and Other Communication Disorders at the National Institutes of Health (NIH/NIDCD 2K24DC012801-0).
Funding Information:
Dr. Martin-Harris and Ms. Kate Davidson report grants from NIH/NIDCD, during the conduct of the study; royalties from Northern Speech Services through Medical University of South Carolina Foundation for Research Development, outside the submitted work. In addition, Dr. Martin-Harris has a patent US 62/710,324 issued. Dr. Theresa Hopkins-Rossabi and Ms. Alkhuwaiter have nothing to disclose.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/4
Y1 - 2022/4
N2 - A widely applied metric for identifying airway invasion events is the Penetration–Aspiration Scale (PAS). PAS scores are often included as primary outcome measures in clinical interventional studies, applied to characterize airway protection in a particular disease, used to establish a normal referent for control group comparisons without dysphagia, and as determinants or predictors of clinical outcomes. Despite the widespread use of the PAS, there is variability in scoring condition. One common method used in research studies includes rater scores applied to each single swallow that occurred during a modified barium swallow study (MBSS) of the same patient. A second common method includes raters scoring single swallow segments that have been spliced from full MBSS from different patients. These single swallow segments are then randomly distributed and the rater is blinded to all swallows that occurred during that patient MBSS. The potential effects of different scoring conditions on rater reliability and score accuracy have not been studied and may have high relevance for the conclusion drawn from the result. The primary aim of this investigation is to determine the impact of two scoring conditions on rater reliability and score accuracy: 1. Contextual, unblinded scoring condition and 2. Randomized, blinded condition. Results of the present study show that no statistically significant differences in PAS rater reliability and score accuracy were found between the two scoring conditions. If findings from this pilot study are reproduced in larger sample sizes, the time and intensity involved in splicing and randomizing MBSS for scoring may not be necessary.
AB - A widely applied metric for identifying airway invasion events is the Penetration–Aspiration Scale (PAS). PAS scores are often included as primary outcome measures in clinical interventional studies, applied to characterize airway protection in a particular disease, used to establish a normal referent for control group comparisons without dysphagia, and as determinants or predictors of clinical outcomes. Despite the widespread use of the PAS, there is variability in scoring condition. One common method used in research studies includes rater scores applied to each single swallow that occurred during a modified barium swallow study (MBSS) of the same patient. A second common method includes raters scoring single swallow segments that have been spliced from full MBSS from different patients. These single swallow segments are then randomly distributed and the rater is blinded to all swallows that occurred during that patient MBSS. The potential effects of different scoring conditions on rater reliability and score accuracy have not been studied and may have high relevance for the conclusion drawn from the result. The primary aim of this investigation is to determine the impact of two scoring conditions on rater reliability and score accuracy: 1. Contextual, unblinded scoring condition and 2. Randomized, blinded condition. Results of the present study show that no statistically significant differences in PAS rater reliability and score accuracy were found between the two scoring conditions. If findings from this pilot study are reproduced in larger sample sizes, the time and intensity involved in splicing and randomizing MBSS for scoring may not be necessary.
KW - Deglutition
KW - Deglutition disorders
KW - Penetration–Aspiration Scale
KW - Reliability
UR - http://www.scopus.com/inward/record.url?scp=85104973098&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85104973098&partnerID=8YFLogxK
U2 - 10.1007/s00455-021-10292-6
DO - 10.1007/s00455-021-10292-6
M3 - Article
C2 - 33880656
AN - SCOPUS:85104973098
SN - 0179-051X
VL - 37
SP - 407
EP - 416
JO - Dysphagia
JF - Dysphagia
IS - 2
ER -