INTER-RATER AGREEMENT OF THE BRIEF BEDSIDE DYSPHAGIA SCREENING TEST-REVISED IN PATIENTS WITH STROKE.

Aim: The aim of the study was to investigate the inter-rater agreement (IRA) of the 8-item Brief Bedside Dysphagia Screening Test-Revised (BBDST-R). Design: An observational IRA study was conducted. Methods: Forty-six patients with stroke were independently assessed by two nurse raters using the BBDST-R. Rater agreement was described and analysed using descriptive statistics, Cohen’s kappa (κ), the proportion of observed agreement (P_o), the prevalence index (p_index ), and the bias index (b_index). Results: Kappa ranged from -0.046 (p = 0.641; 95% CI = -0.126–0.034) for item “ability to clench the teeth” to 0.784 (p < 0.001; 95% CI = 0.377–1.000) for “thick liquid: cough”. For the overall BBDST-R result, κ was 0.241 (p = 0.114; 95% CI = 0.000–0.558). The P_o was ≥ 0.80 for five items; the p_index was ≥ 0.80 for three items. The b_index ranged from 0.03–0.31. Conclusion: The IRA, as expressed by κ, was low for the overall result and variable for the individual items. However, for some items, κ may have misrepresented the IRA due to the high p_index and b_index. Several strategies are recommended to improve the IRA of the instrument. This should enhance the instrument’s capacity to produce consistent results across raters. [ABSTRACT FROM AUTHOR]