{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:14:13Z","timestamp":1789179253707,"version":"build-2803163510"},"reference-count":8,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,15]],"date-time":"2019-01-15T00:00:00Z","timestamp":1547510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>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\u2010Kushner scale (GKS) after viewing the VIT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Multi\u2010institutional.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixteen fellowship\u2010trained 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 \u03ba coefficient was used for categorical variables. Wilcoxon signed\u2010rank test was performed on the difference between the pre\/post individual video ratings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Reliability improved for all continuous variables after watching the instructional video. The improvement was significant for PPW (0.22\u20100.30, <jats:italic>P<\/jats:italic> &lt;. 001), SP (left: 0.63\u20100.68, <jats:italic>P<\/jats:italic> &lt;. 001 and right: 0.64\u20100.68, <jats:italic>P<\/jats:italic> =. 001), and LPW (left: 0.49\u20100.54, <jats:italic>P<\/jats:italic> =. 01 and right: 0.49\u20100.54, <jats:italic>P<\/jats:italic> =. 09) but not significant for gap size (0.65\u20100.69, <jats:italic>P<\/jats:italic> =. 36). Among categorical variables, agreement on Passavant's ridge significantly improved (0.30\u20100.36, <jats:italic>P<\/jats:italic> =. 03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599818822989","type":"journal-article","created":{"date-parts":[[2019,1,15]],"date-time":"2019-01-15T05:00:13Z","timestamp":1547528413000},"page":"720-728","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Multicenter Interrater Reliability in the Endoscopic Assessment of Velopharyngeal Function Using a Video Instruction Tool"],"prefix":"10.1002","volume":"160","author":[{"given":"Craig","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Otolaryngology: Head &amp; Neck Surgery University of Washington School of Medicine Seattle Washington USA"},{"name":"Seattle Children's Hospital Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Bly","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology: Head &amp; Neck Surgery University of Washington School of Medicine Seattle Washington USA"},{"name":"Seattle Children's Hospital Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelagh","family":"Cofer","sequence":"additional","affiliation":[{"name":"Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Dahl","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology: Head &amp; Neck Surgery University of Washington School of Medicine Seattle Washington USA"},{"name":"Seattle Children's Hospital Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianne","family":"de Serres","sequence":"additional","affiliation":[{"name":"Maria Fareri Children's Hospital Westchester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Goudy","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta Emory University Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry","family":"Hartzell","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh of UPMC Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Kacmarysnki","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Macarthur","sequence":"additional","affiliation":[{"name":"Doernbacher Children's Hospital Oregon Health Sciences University Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Messner","sequence":"additional","affiliation":[{"name":"Lucille Packard Children's Hospital Stanford University Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Milczuk","sequence":"additional","affiliation":[{"name":"Doernbacher Children's Hospital Oregon Health Sciences University Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Rastatter","sequence":"additional","affiliation":[{"name":"Ann &amp; Robert H. Lurie Children's Hospital of Chicago Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura H.","family":"Swibel Rosenthal","sequence":"additional","affiliation":[{"name":"Ann &amp; Robert H. Lurie Children's Hospital of Chicago Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Scott","sequence":"additional","affiliation":[{"name":"Floating Hospital for Children Tufts University Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis","family":"Tollefson","sequence":"additional","affiliation":[{"name":"UC Davis Children's Hospital University of California\u2013Davis Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audie","family":"Woolley","sequence":"additional","affiliation":[{"name":"Children's of Alabama Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlton","family":"Zdanski","sequence":"additional","affiliation":[{"name":"University of North Carolina\u2013Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dave A.","family":"Zopf","sequence":"additional","affiliation":[{"name":"University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Sie","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology: Head &amp; Neck Surgery University of Washington School of Medicine Seattle Washington USA"},{"name":"Seattle Children's Hospital Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/74.8.777"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.134.7.757"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569(1990)027<0337:SFTRON>2.3.CO;2"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.132.9.947"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.2013.203"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780060404"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599818822989","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599818822989","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599818822989","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:24:19Z","timestamp":1760955859000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599818822989"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,15]]},"references-count":8,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1177\/0194599818822989"],"URL":"https:\/\/doi.org\/10.1177\/0194599818822989","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,15]]},"assertion":[{"value":"2018-06-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}