Interformat Reliability of Web-Based Parent-Rated Questionnaires for Assessing Neurodevelopmental Disorders Among Preschoolers: Cross-sectional Community Study

Background Early detection and intervention for neurodevelopmental disorders are effective. Several types of paper questionnaires have been developed to assess these conditions in early childhood; however, the psychometric equivalence between the web-based and the paper versions of these questionnaires is unknown. Objective This study examined the interformat reliability of the web-based parent-rated version of the Autism Spectrum Screening Questionnaire (ASSQ), Attention-Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS), Developmental Coordination Disorder Questionnaire 2007 (DCDQ), and Strengths and Difficulties Questionnaire (SDQ) among Japanese preschoolers in a community developmental health check-up setting. Methods A set of paper-based questionnaires were distributed for voluntary completion to parents of children aged 5 years. The package of the paper format questionnaires included the ASSQ, ADHD-RS, DCDQ, parent-reported SDQ (P-SDQ), and several additional demographic questions. Responses were received from 508 parents of children who agreed to participate in the study. After 3 months, 300 parents, who were among the initial responders, were randomly selected and asked to complete the web-based versions of these questionnaires. A total of 140 parents replied to the web-based format and were included as a final sample in this study. Results We obtained the McDonald ω coefficients for both the web-based and paper formats of the ASSQ (web-based: ω=.90; paper: ω=.86), ADHD-RS total and subscales (web-based: ω=.88-.94; paper: ω=.87-.93), DCDQ total and subscales (web-based: ω=.82-.94; paper: ω=.74-.92), and P-SDQ total and subscales (web-based: ω=.55-.81; paper: ω=.52-.80). The intraclass correlation coefficients between the web-based and paper formats were all significant at the 99.9% confidence level: ASSQ (r=0.66, P<.001); ADHD-RS total and subscales (r=0.66-0.74, P<.001); DCDQ total and subscales (r=0.66-0.71, P<.001); P-SDQ Total Difficulties and subscales (r=0.55-0.73, P<.001). There were no significant differences between the web-based and paper formats for total mean score of the ASSQ (P=.76), total (P=.12) and subscale (P=.11-.47) mean scores of DCDQ, and the P-SDQ Total Difficulties mean score (P=.20) and mean subscale scores (P=.28-.79). Although significant differences were found between the web-based and paper formats for mean ADHD-RS scores (total: t132=2.83, P=.005; Inattention subscale: t133=2.15, P=.03; Hyperactivity/Impulsivity subscale: t133=3.21, P=.002), the effect sizes were small (Cohen d=0.18-0.22). Conclusions These results suggest that the web-based versions of the ASSQ, ADHD-RS, DCDQ, and P-SDQ were equivalent, with the same level of internal consistency and intrarater reliability as the paper versions, indicating the applicability of the web-based versions of these questionnaires for assessing neurodevelopmental disorders.

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Interformat Reliability of Web-Based Parent-Rated Questionnaires Assessing for Neurodevelopmental Disorders among Preschoolers: A Community Developmental Health Check-up Setting Study (Preprint)

10.2196/preprints.20172 ◽

2020 ◽

Author(s):

Masanori Tanaka ◽

Manabu Saito ◽

Michio Takahashi ◽

Masaki Adachi ◽

Kazuhiko Nakamura

Keyword(s):

Neurodevelopmental Disorders ◽

Rating Scale ◽

Developmental Coordination Disorder ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Autism Spectrum ◽

Health Check ◽

Web Based ◽

Developmental Health ◽

The Web

BACKGROUND Early detection and intervention for neurodevelopmental disorders are effective. Several paper types of questionnaires have been developed to assess these conditions in early childhood. However, the psychometric equivalence between the web and the paper versions of these questionnaires is unknown. OBJECTIVE This study examined the interformat reliability of the web-based parent-rated version of the Autism Spectrum Screening Questionnaire (ASSQ), Attention-Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS), Developmental Coordination Disorder Questionnaire’07 (DCDQ), and Strengths and Difficulties Questionnaire (SDQ) among Japanese preschoolers in a community developmental health check-up setting. METHODS A set of paper-based questionnaires were distributed for voluntary completion to parents of children aged 5 years. The package of the paper form questionnaires included the ASSQ, ADHD-RS, DCDQ, Parent-reported SDQ (P-SDQ), and several additional demographic questions. Responses were received from 508 parents of children who agreed to participate in the study. After 3 months, 300 parents of children, who were among the initial responders, were randomly selected and asked to complete the web-based versions of these questionnaires voluntarily. A total of 140 parents of children replied to the web form and were included as a final sample in this study. RESULTS We obtained Cronbach’s alphas for both the web and paper forms of the ASSQ (web=.88, paper=.84), ADHD-RS total and subscales (web=.87-.94, paper=.86-.92), DCDQ total and subscales (web=.81-.93, paper=.74-.91), and P-SDQ Total Difficulties and subscales (web=.52-.80, paper=.51-.79). The intraclass correlation coefficients between the web and paper forms of each questionnaire were all significant at the 99.9% confidence level. (ASSQ: r=.66; ADHD-RS total and subscales: r=.66-74; DCDQ total and subscales: r=.66-.71; P-SDQ Total Difficulties and subscales: r=.55-.73). There were no significant differences between the web and paper forms for the total mean score of the ASSQ, total and subscale mean scores of DCDQ, and the P-SDQ Total Difficulties mean score and mean subscale scores. While significant differences were found between the web and paper forms for the mean scores on the ADHD-RS (Total: t132=2.83, P=.005; Inattention: t133=2.15, P=.03; Hyperactivity/Impulsivity: t133=3.21, P=.002), the effect sizes were small (Cohen d=.18-.22). CONCLUSIONS These results suggest that the web versions of the ASSQ, ADHD-RS, DCDQ, and P-SDQ had the same level of internal consistency, intra-rater reliability, and equality as the paper versions. These results indicate the web applicability of these questionnaires for assessing neurodevelopmental disorders.

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Web-based Food Behaviour Questionnaire: Validation with Grades Six to Eight Students

Canadian Journal of Dietetic Practice and Research ◽

10.3148/70.4.2009.172 ◽

2009 ◽

Vol 70 (4) ◽

pp. 172-178 ◽

Cited By ~ 55

Author(s):

Rhona M. Hanning ◽

Dawna Royall ◽

Jenn E. Toews ◽

Lindsay Blashill ◽

Jessica Wegener ◽

...

Keyword(s):

Dietary Assessment ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Food Group ◽

Nutrient Intakes ◽

Web Based ◽

Qualitative Feedback ◽

Diet Recall ◽

Ethnic Students ◽

The Web

Purpose: The web-based Food Behaviour Questionnaire (FBQ) includes a 24-hour diet recall, a food frequency questionnaire, and questions addressing knowledge, attitudes, intentions, and food-related behaviours. The survey has been revised since it was developed and initially validated. The current study was designed to obtain qualitative feedback and to validate the FBQ diet recall. Methods: “Think aloud” techniques were used in cognitive interviews with dietitian experts (n=11) and grade six students (n=21).Multi-ethnic students (n=201) in grades six to eight at urban southern Ontario schools completed the FBQ and, subsequently, one-on-one diet recall interviews with trained dietitians. Food group and nutrient intakes were compared. Results: Users provided positive feedback on the FBQ. Suggestions included adding more foods, more photos for portion estimation, and online student feedback. Energy and nutrient intakes were positively correlated between FBQ and dietitian interviews, overall and by gender and grade (all p<0.001). Intraclass correlation coefficients were ≥0.5 for energy and macronutrients, although the web-based survey underestimated energy (-10.5%) and carbohydrate (-15.6%) intakes (p<0.05). Under-estimation of rice and pasta portions on the web accounted for 50% of this discrepancy. Conclusions: The FBQ is valid, relative to 24-hour recall interviews, for dietary assessment in diverse populations of Ontario children in grades six to eight.

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Actionable and incidental neuroradiological findings in twins with neurodevelopmental disorders

Scientific Reports ◽

10.1038/s41598-020-79959-8 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Lynnea Myers ◽

Mai-Lan Ho ◽

Elodie Cauvet ◽

Karl Lundin ◽

Torkel Carlsson ◽

...

Keyword(s):

Neurodevelopmental Disorders ◽

Copy Number Variants ◽

Cross Sectional Study ◽

Autism Spectrum ◽

Molecular Signaling ◽

Mri Findings ◽

Cross Sectional ◽

Increased Risk ◽

Magnetic Resonance Imaging Mri ◽

Morphological Variants

AbstractWhile previous research has investigated neuroradiological findings in autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD), the entire range of neurodevelopmental disorders (NDDs) has not yet been well-studied using magnetic resonance imaging (MRI). Considering the overlap among NDDs and simultaneous development of the brain and face, guided by molecular signaling, we examined the relationship of actionable and incidental (non-actionable) MRI findings and NDD diagnoses together with facial morphological variants and genetic copy number variants (CNVs). A cross-sectional study was conducted with a twin cohort 8–36 years of age (57% monozygotic, 40% dizygotic), including 372 subjects (46% with NDDs; 47% female) imaged by MRI, 280 with data for facial morphological variants, and 183 for CNVs. Fifty-one percent of participants had MRI findings. Males had a statistically significantly higher percentage of MRI findings (57.7%) compared with females (43.8%, p = 0.03). Twin zygosity was not statistically significantly correlated with incidence or severity of specific MRI findings. No statistically significant association was found between MRI findings and any NDD diagnosis or facial morphological variants; however, MRI findings were statistically significantly associated with the number of CNVs (OR 1.20, 95% CI 1.00–1.44, p = 0.05, adjusted OR for sex 1.24, 95% CI 1.03–1.50, p = 0.02). When combining the presence of MRI findings, facial morphological variants, and CNVs, statistically significant relationships were found with ASD and ADHD diagnoses (p = 0.0006 and p = 0.002, respectively). The results of this study demonstrate that the ability to identify NDDs from combined radiology, morphology, and CNV assessments may be possible. Additionally, twins do not appear to be at increased risk for neuroradiological variants.

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The Reliability of Iodine Concentration in Diaper-Retrieved Infant Urine Using Urine Collection Pads, and in Their Mothers’ Breastmilk

Biomolecules ◽

10.3390/biom10020295 ◽

2020 ◽

Vol 10 (2) ◽

pp. 295

Author(s):

Kjersti Sletten Bakken ◽

Ingvild Oma ◽

Synne Groufh-Jacobsen ◽

Beate Stokke Solvik ◽

Lise Mette Mosand ◽

...

Keyword(s):

Intraclass Correlation ◽

Urinary Iodine ◽

Correlation Coefficients ◽

Iodine Concentration ◽

Cross Sectional Study ◽

Iodine Intake ◽

Public Healthcare ◽

Urinary Iodine Concentration ◽

Childbearing Age ◽

Cross Sectional

Mild to moderate iodine deficiency is common among women of childbearing age. Data on iodine status in infants are sparse, partly due to the challenges in collecting urine. Urinary iodine concentration (UIC) is considered a good marker for recent dietary iodine intake and status in populations. The aim of this study was to investigate the reliability of iodine concentration measured in two spot-samples from the same day of diaper-retrieved infant urine and in their mothers’ breastmilk. We collected urine and breastmilk from a sample of 27 infants and 25 mothers participating in a cross-sectional study at two public healthcare clinics in Norway. The reliability of iodine concentration was assessed by calculating the intraclass correlation coefficients (ICC) and the coefficient of variation (CV). The ICC for infants’ urine was 0.64 (95% confidence interval (CI) 0.36–0.82), while the ICC for breastmilk was 0.83 (95% CI 0.65–0.92) Similarly, the intraindividual CV for UIC was 0.25 and 0.14 for breastmilk iodine concentration (BIC). Compared to standard methods of collecting urine for measuring iodine concentration, the diaper-pad collection method does not substantially affect the reliability of the measurements.

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Music Therapy for Children With Autistic Spectrum Disorder and/or Other Neurodevelopmental Disorders: A Systematic Review

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.643234 ◽

2021 ◽

Vol 12 ◽

Author(s):

Hanna Mayer-Benarous ◽

Xavier Benarous ◽

François Vonthron ◽

David Cohen

Keyword(s):

Systematic Review ◽

Music Therapy ◽

Neurodevelopmental Disorders ◽

Developmental Coordination Disorder ◽

Case Reports ◽

Preliminary Evidence ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Improvisational Music Therapy ◽

Positive Effect

Background: Several studies have reported contradictory results regarding the benefits of music interventions in children and adolescents with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD).Methods: We performed a systematic review according to the PRISMA guidelines. We searched the Cochrane, PubMed and Medline databases from January 1970 to September 2020 to review all empirical findings, except case reports, measuring the effect of music therapy on youths with ASD, intellectual disability (ID), communication disorder (CD), developmental coordination disorder (DCD), specific learning disorder, and attention/deficit hyperactivity disorder (ADHD).Results: Thirty-nine studies (N = 1,774 participants) were included in this review (ASD: n = 22; ID: n = 7; CD and dyslexia: n = 5; DCD: n = 0; ADHD: n = 5 studies). Two main music therapies were used: educational music therapy and improvisational music therapy. A positive effect of educational music therapy on patients with ASD was reported in most controlled studies (6/7), particularly in terms of speech production. A positive effect of improvisational music therapy was reported in most controlled studies (6/8), particularly in terms of social functioning. The subgroup of patients with both ASD and ID had a higher response rate. Data are lacking for children with other NDDs, although preliminary evidence appears encouraging for educational music therapy in children with dyslexia.Discussion: Improvisational music therapy in children with NDDs appears relevant for individuals with both ASD and ID. More research should be encouraged to explore whether oral and written language skills may improve after educational music therapy, as preliminary data are encouraging.

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A Quantitative Comparison of Multispectral Refraction Topography and Autorefractometer in Young Adults

Frontiers in Medicine ◽

10.3389/fmed.2021.715640 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yunru Liao ◽

Zhenlan Yang ◽

Zijing Li ◽

Rui Zeng ◽

Jing Wang ◽

...

Keyword(s):

Correlation Coefficient ◽

Pearson Correlation ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Cross Sectional Study ◽

Cross Sectional ◽

High Agreement ◽

Intraclass Correlation Coefficients ◽

Repeatability And Reproducibility ◽

The Mean

Purpose: Purpose of this study is to evaluate the measuring consistency of central refraction between multispectral refraction topography (MRT) and autorefractometry.Methods: This was a descriptive cross-sectional study including subjects in Sun Yat-sen Memorial Hospital from September 1, 2020, to December 31, 2020, ages 20 to 35 years with a best corrected visual acuity of 20/20 or better. All patients underwent cycloplegia, and the refractive status was estimated with autorefractometer, experienced optometrist and MRT. We analyzed the central refraction of the autorefractometer and MRT. The repeatability and reproducibility of values measured using both devices were evaluated using intraclass correlation coefficients (ICCs).Results: A total of 145 subjects ages 20 to 35 (290 eyes) were enrolled. The mean central refraction of the autorefractometer was −4.69 ± 2.64 diopters (D) (range −9.50 to +4.75 D), while the mean central refraction of MRT was −4.49 ± 2.61 diopters (D) (range −8.79 to +5.02 D). Pearson correlation analysis revealed a high correlation between the two devices. The intraclass correlation coefficient (ICC) also showed high agreement. The intrarater and interrater ICC values of central refraction were more than 0.90 in both devices and conditions. At the same time, the mean central refraction of experienced optometrist was −4.74 ± 2.66 diopters (D) (range −9.50 to +4.75D). The intra-class correlation coefficient of central refraction measured by MRT and subjective refraction was 0.939.Conclusions: Results revealed that autorefractometry, experienced optometrist and MRT show high agreement in measuring central refraction. MRT could provide a potential objective method to assess peripheral refraction.

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The Arabic Version of the Mobile App Rating Scale: Development and Validation Study (Preprint)

10.2196/preprints.16956 ◽

2019 ◽

Author(s):

Marco Bardus ◽

Nathalie Awada ◽

Lilian A Ghandour ◽

Elie-Jacques Fares ◽

Tarek Gherbal ◽

...

Keyword(s):

Weight Management ◽

Information Quality ◽

Rating Scale ◽

Arab World ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Mobile App ◽

Health Apps ◽

Highly Correlated

BACKGROUND With thousands of health apps in app stores globally, it is crucial to systemically and thoroughly evaluate the quality of these apps due to their potential influence on health decisions and outcomes. The Mobile App Rating Scale (MARS) is the only currently available tool that provides a comprehensive, multidimensional evaluation of app quality, which has been used to compare medical apps from American and European app stores in various areas, available in English, Italian, Spanish, and German. However, this tool is not available in Arabic. OBJECTIVE This study aimed to translate and adapt MARS to Arabic and validate the tool with a sample of health apps aimed at managing or preventing obesity and associated disorders. METHODS We followed a well-established and defined “universalist” process of cross-cultural adaptation using a mixed methods approach. Early translations of the tool, accompanied by confirmation of the contents by two rounds of separate discussions, were included and culminated in a final version, which was then back-translated into English. Two trained researchers piloted the MARS in Arabic (MARS-Ar) with a sample of 10 weight management apps obtained from Google Play and the App Store. Interrater reliability was established using intraclass correlation coefficients (ICCs). After reliability was ascertained, the two researchers independently evaluated a set of additional 56 apps. RESULTS MARS-Ar was highly aligned with the original English version. The ICCs for MARS-Ar (0.836, 95% CI 0.817-0.853) and MARS English (0.838, 95% CI 0.819-0.855) were good. The MARS-Ar subscales were highly correlated with the original counterparts (P<.001). The lowest correlation was observed in the area of usability (r=0.685), followed by aesthetics (r=0.827), information quality (r=0.854), engagement (r=0.894), and total app quality (r=0.897). Subjective quality was also highly correlated (r=0.820). CONCLUSIONS MARS-Ar is a valid instrument to assess app quality among trained Arabic-speaking users of health and fitness apps. Researchers and public health professionals in the Arab world can use the overall MARS score and its subscales to reliably evaluate the quality of weight management apps. Further research is necessary to test the MARS-Ar on apps addressing various health issues, such as attention or anxiety prevention, or sexual and reproductive health.

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Infant with Clefts Observation Outcomes Instrument (iCOO): A New Outcome for Infants and Young Children with Orofacial Clefts

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211040307 ◽

2021 ◽

pp. 105566562110403

Author(s):

Todd C. Edwards ◽

Carrie L. Heike ◽

Kathleen A. Kapp-Simon ◽

Salene M. Jones ◽

Brian G. Leroux ◽

...

Keyword(s):

Cleft Lip ◽

Intraclass Correlation ◽

Primary Caregivers ◽

Correlation Coefficients ◽

Measurement Properties ◽

Cross Sectional ◽

Scale Scores ◽

Health Domains ◽

And Function ◽

The Impact

Objective We evaluated the measurement properties for item and domain scores of the Infant with Clefts Observation Outcomes Instrument (iCOO). Design Cross-sectional (before lip surgery) and longitudinal study (preoperative baseline and 2 days and 2 months after lip surgery). Setting Three academic craniofacial centers and national online advertisements. Participants Primary caregivers with an infant with cleft lip with or without cleft palate (CL ± P) scheduled to undergo primary lip repair. There were 133 primary caregivers at baseline, 115 at 2 days postsurgery, and 112 at 2 months postsurgery. Main Outcome Measure(s) Caregiver observation items ( n = 61) and global impression of health and function items ( n = 8) across eight health domains. Results Mean age at surgery was 6.0 months (range 2.7-11.8 months). Five of eight iCOO domains have scale scores, with Cronbach’s alphas ranging from 0.67 to 0.87. Except for the Facial Skin and Mouth domain, iCOO scales had acceptable intraclass correlation coefficients (ICCs) ranging from 0.76 to 0.84. The internal consistency of the Global Impression items across all domains was 0.90 and had acceptable ICCs (range 0.76-0.91). Sixteen out of 20 (nonscale) items had acceptable ICCs (range 0.66-0.96). As anticipated, iCOO scores 2 days postoperatively were generally lower than baseline and scores 2 months postsurgery were consistent with baseline or higher. The iCOO took approximately 10 min to complete. Conclusions The iCOO meets measurement standards and may be used for assessing the impact of cleft-related treatments in clinical research and care. More research is needed on its use in various treatment contexts.

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Validation of the Three-Item Skindex-Mini Among Hidradenitis Suppurativa Patients With Diverse Racial Backgrounds

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475420930222 ◽

2020 ◽

Vol 24 (5) ◽

pp. 457-460

Author(s):

Lauren A.V. Orenstein ◽

Adaugo Amah ◽

Fiona M. Shaw ◽

Chao Zhang ◽

Robert A. Swerlick ◽

...

Keyword(s):

Hidradenitis Suppurativa ◽

Rating Scale ◽

Clinical Care ◽

Pearson Correlation ◽

Life Quality ◽

Correlation Coefficients ◽

Numeric Rating Scale ◽

Secondary Outcome ◽

Cross Sectional ◽

And Function

Background Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that severely impairs patients’ quality of life (QoL). Instruments such as the 10-item Dermatology Life Quality Index and 16-item Skindex-16 have been used to assess QoL in HS; however, it is unknown whether the shorter 3-item Skindex-mini can also provide an accurate assessment of skin-related QoL in patients with HS. Objectives The aim was to assess how well the Skindex-16 correlates with its shorter adaptation, the Skindex-mini, in capturing QoL among patients with HS. Methods This retrospective cross-sectional study included all HS patients seen in the HS Clinic at The Emory Clinic between January 1, 2019, and August 16, 2019. We compared the correlation between the symptom, emotion, and function domains of the Skindex-16 and Skindex-mini using Pearson correlation coefficients (CC). Secondary outcome measures included individual survey item analysis, ItchyQuant scores, and numeric rating scale of pain. Results We identified 108 encounters among 75 unique hidradenitis suppurativa patients (43 black/African American, 18 white, 5 Asian/Pacific Islander, 3 Latino, 4 Other, 2 unknown). Pearson CC between the Skindex-16 and Skindex-mini domain scores for all encounters were 0.770 ( P < .001), 0.787 ( P < .001), and 0.801 ( P < .001) for the symptom, emotion, and function domains, respectively. The mean pain and ItchyQuant scores were 4.14 (SD 3.31) and 3.55 (SD 3.34), respectively. Conclusions The Skindex-mini correlated highly with the Skindex-16 in a racially diverse group of patients with HS. The Skindex-mini is a streamlined QoL instrument that could be practically implemented into routine clinical care among diverse patients presenting to dermatology.

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Bolus Residue Scale: An Easy-to-Use and Reliable Videofluoroscopic Analysis Tool to Score Bolus Residue in Patients with Dysphagia

International Journal of Otolaryngology ◽

10.1155/2015/780197 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 11

Author(s):

Nathalie Rommel ◽

Charlotte Borgers ◽

Dirk Van Beckevoort ◽

Ann Goeleven ◽

Eddy Dejaeger ◽

...

Keyword(s):

Rating Scale ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Posterior Pharyngeal Wall ◽

High Specificity ◽

Analysis Tool ◽

Pharyngeal Wall ◽

Specificity And Sensitivity ◽

Low Sensitivity ◽

Sensitivity Specificity

Background. We aimed to validate an easy-to-use videofluoroscopic analysis tool, the bolus residue scale (BRS), for detection and classification of pharyngeal retention in the valleculae, piriform sinuses, and/or the posterior pharyngeal wall.Methods. 50 randomly selected videofluoroscopic images of 10 mL swallows (recorded in 18 dysphagia patients and 8 controls) were analyzed by 4 experts and 6 nonexpert observers. A score from 1 to 6 was assigned according to the number of structures affected by residue. Inter- and intrarater reliabilities were assessed by calculation of intraclass correlation coefficients (ICCs) for expert and nonexpert observers. Sensitivity, specificity, and interrater agreement were analyzed for different BRS levels.Results. Intrarater reproducibility was almost perfect for experts (mean ICC 0.972) and ranged from substantial to almost perfect for nonexperts (mean ICC 0.835). Interjudge agreement of the experts ranged from substantial to almost perfect (mean ICC 0.780), but interrater reliability of nonexperts ranged from substantial to good (mean 0.719). BRS shows for experts a high specificity and sensitivity and for nonexperts a low sensitivity and high specificity.Conclusions. The BRS is a simple, easy-to-carry-out, and accessible rating scale to locate pharyngeal retention on videofluoroscopic images with a good specificity and reproducibility for observers of different expertise levels.

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