Structural Validity, Internal Consistency, and Rater Reliability of the Modified Barium Swallow Impairment Profile: Breaking Ground on a 52,726-Patient, Clinical Data Set

Abstract

Purpose: The purpose of this study was to extend the assessment of the psychometric properties of the Modified Barium Swallow Impairment Profile (MBSImP). Here, we re-examined structural validity and internal consistency using a large clinical-registry data set and formally examined rater reliability in a smaller data set. Method: This study consists of a retrospective structural validity and internal consistency analysis of MBSImP using a large data set ( N = 52,726) drawn from the MBSImP Swallowing Data Registry and a prospective study of the interrater and intrarater reliability of a subset of studies ( N = 50) rated by four MBSImP-trained speech-language pathologists. Structural validity was assessed via exploratory factor analysis. Internal consistency was measured using Cronbach's alpha for each of the multicomponent MBSImP domains, namely, the oral and pharyngeal domains. Interrater reliability and intrarater reliability were measured using the intraclass correlation coefficient (ICC). Results: The exploratory factor analysis showed a two-factor solution with factors precisely corresponding to the scale's oral and pharyngeal domains, consistent with findings from the initial study. Component 17, that is, the esophageal domain, did not load onto either factor. Internal consistency was good for both the oral and pharyngeal domains (α oral = .81, α pharyngeal = .87). Interrater reliability was found to be good with ICC interrater = .78 (95% confidence interval [CI; .76, .80]). Intrarater reliability was good for each rater, ICC Rater-1 = .82 (95% CI [.77, .86]), ICC Rater-2 = .83 (95% CI [.79, .87]), ICC Rater-3 = .87 (95% CI [.83, .90]), and ICC Rater-4 = .87 (95% CI [.83, .90]). Conclusions: This study leverages a large-scale, clinical data set to provide strong, generalizable evidence that the MBSImP assessment method has excellent structural validity and internal consistency. In addition, the results show that MBSImP-trained speech-language pathologists can demonstrate good interrater and intrarater reliability.

Auditory-Perceptual Assessments of Cough: Characterizing Rater Reliability and the Effects of a Standardized Training Protocol

“…From a voice standpoint, the reliability coefficients from the present study were within the range of those reported for auditory-perceptual assessments of voice, as previously outlined. Similarly, from a swallowing standpoint, the reliability coefficients in the present study are consistent with those frequently reported for visualperceptual assessments of swallowing, including measures related to pharyngeal residue [58][59][60][61], penetration/ aspiration [60][61][62][63][64], and swallowing physiology [65][66][67]. Lastly, while the reliability of acoustic and aerodynamic instrumental cough assessment measures is not routinely reported in research, current data demonstrate reliability coefficients range from 0.61 to 0.89 for non-automated measures (e.g., number of coughs, compression phase duration, peak flow rise time, inspiratory/expiratory volume) and 0.90-0.99 for automated measures (e.g., peak flow rate) [68][69][70][71][72][73][74][75][76][77].…”

Normal Variations in Upper Esophageal Sphincter Function During Deglutition: A Secondary Analysis of Videofluoroscopic Data

“…Thus, it is crucial to consider the current state of VFSS‐based research focused on normal UES function. A lack of well‐tested and validated swallow task procedures, such as the Modified Barium Swallow Impairment Profile (MBSImP) protocol, have been applied to test normal UES function 34–37 . Studies have explored an array of contextual factors on UESOdur and UESmax, including age, 19,20,23–25,28–30,32 sex, 19,20,23–26,30,31,33 viscosity, 19–21,30,31 and volume, 19,22,25–27,29,31–33 but we are unaware of a single, large‐scale study that has investigated the collective interaction of all these factors using a wide range of standardized swallow tasks that have been well‐tested to identify swallowing impairment accurately.…”

“…A lack of well-tested and validated swallow task procedures, such as the Modified Barium Swallow Impairment Profile (MBSImP) protocol, have been applied to test normal UES function. [34][35][36][37] Studies have explored an array of contextual factors on UESOdur and UESmax, including age, 19,20,[23][24][25][28][29][30]32 sex, 19,20,[23][24][25][26]30,31,33 viscosity, [19][20][21]30,31 and volume, 19,22,[25][26][27]29,[31][32][33] but we are unaware of a single, large-scale study that has investigated the collective interaction of all these factors using a wide range of standardized swallow tasks that have been well-tested to identify swallowing impairment accurately. These current research gaps limit the overall context in which these measures can be interpreted clinically.…”