Craig Miller1,2, Randall Bly1,2, Shelagh Cofer3, John P Dahl1,2, Lianne de Serres4, Steven Goudy5, Larry Hartzell6, Noel Jabbour7, Deborah Kacmarysnki8, Carol Macarthur9, Anna Messner10, Henry Milczuk9, Jeff Rastatter11, Laura H Swibel Rosenthal11, Andrew Scott12, Travis Tollefson13, Audie Woolley14, Carlton Zdanski15, Dave A Zopf16, Kathleen Sie1,2. 1. 1 Department of Otolaryngology: Head & Neck Surgery, University of Washington School of Medicine, Seattle, Washington, USA. 2. 2 Seattle Children's Hospital, Seattle, Washington, USA. 3. 3 Mayo Clinic, Rochester, Minnesota, USA. 4. 4 Maria Fareri Children's Hospital, Westchester, New York, USA. 5. 5 Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA. 6. 6 University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. 7. 7 Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA. 8. 8 University of Iowa Health Care, Iowa City, Iowa, USA. 9. 9 Doernbacher Children's Hospital, Oregon Health Sciences University, Portland, Oregon, USA. 10. 10 Lucille Packard Children's Hospital, Stanford University, Palo Alto, California, USA. 11. 11 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA. 12. 12 Floating Hospital for Children, Tufts University, Boston, Massachusetts, USA. 13. 13 UC Davis Children's Hospital, University of California-Davis, Sacramento, California, USA. 14. 14 Children's of Alabama, Birmingham, Alabama, USA. 15. 15 University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA. 16. 16 University of Michigan, Ann Arbor, Michigan, USA.
Abstract
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.
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.
Authors: Austin S Lam; Michael D Bindschadler; Kelly N Evans; Seth D Friedman; Matthew S Blessing; Randall Bly; Michael L Cunningham; Mark A Egbert; Russell E Ettinger; Emily R Gallagher; Richard A Hopper; Kaalan Johnson; Jonathan A Perkins; Erin K Romberg; Kathleen C Y Sie; Srinivas M Susarla; Carlton J Zdanski; Xing Wang; Jeffrey P Otjen; Francisco A Perez; John P Dahl Journal: Otolaryngol Head Neck Surg Date: 2021-07-13 Impact factor: 3.497
Authors: Austin S Lam; Erin M Kirkham; John P Dahl; Sara L Kinter; Jonathan A Perkins; Kathleen C Y Sie Journal: Laryngoscope Date: 2020-10-26 Impact factor: 2.970