{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:59:29Z","timestamp":1785761969079,"version":"3.56.0"},"reference-count":29,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Visuoperceptual evaluation of fiberoptic endoscopic evaluation of swallowing (FEES) is a commonly used assessment in dysphagia or swallowing disorders. Currently, no international consensus exists regarding which visuoperceptual measures to use for the analysis of FEES recordings. Moreover, existing visuoperceptual FEES measures are limited by poor and incomplete psychometric data, identifying an urgent need for developing a visuoperceptual measure to interpret FEES recordings. Following the COSMIN group\u2019s (COnsensus-based Standards for the selection of health Measurement INstruments) psychometric taxonomy and guidelines, this study aimed to establish the content validity of a new visuoperceptual FEES (V-FEES) measure in adults with oropharyngeal dysphagia. Using the Delphi technique, international consensus was achieved among dysphagia experts across 21 countries, resulting in a new prototype measure for V-FEES, comprising 30 items, 8 function testing items (i.e., specific tasks performed by patients while observing and rating items), and 36 unique operationalisations (i.e., defining items into measurable factors that could be measured empirically using visuoperceptual observation). This study supports good content validity for V-FEES, including participants\u2019 feedback on the relevance, comprehensiveness, and comprehensibility of the included items. Future studies will continue the instrument development process and determine the remaining psychometric properties using both the classic test theory (CTT) and item response theory (IRT) models.<\/jats:p>","DOI":"10.3390\/jcm12123875","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T02:02:15Z","timestamp":1686103335000},"page":"3875","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Development of a Visuoperceptual Measure for Fiberoptic Endoscopic Evaluation of Swallowing (V-FEES) in Adults with Oropharyngeal Dysphagia: An International Delphi Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9906-5300","authenticated-orcid":false,"given":"Reinie","family":"Cordier","sequence":"first","affiliation":[{"name":"Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne NE7 7XA, UK"},{"name":"Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth 6102, Australia"},{"name":"Department of Health & Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2828-8897","authenticated-orcid":false,"given":"Ren\u00e9e","family":"Speyer","sequence":"additional","affiliation":[{"name":"Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth 6102, Australia"},{"name":"Department Special Needs Education, University of Oslo, 0318 Oslo, Norway"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, 1233 Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0521-7375","authenticated-orcid":false,"given":"Susan","family":"Langmore","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head-Neck Surgery, Boston University School of Medicine, Boston, MA 02118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8264-6160","authenticated-orcid":false,"given":"Deborah","family":"Denman","sequence":"additional","affiliation":[{"name":"Department of Linguistics, Macquarie University, Sydney 2109, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4530-5548","authenticated-orcid":false,"given":"Katina","family":"Swan","sequence":"additional","affiliation":[{"name":"Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth 6102, Australia"},{"name":"St John of God Midland Public and Private Hospitals, St John of God Health Care, Perth 6056, Australia"},{"name":"Department of Allied Health, The School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8139-4990","authenticated-orcid":false,"given":"Daniele","family":"Farneti","sequence":"additional","affiliation":[{"name":"Audiologic Phoniatric Service, Otorhinolaryngology Department, Infermi Hospital, AUSL Romagna, 47900 Rimini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/BF02414429","article-title":"Fiberoptic endoscopic examination of swallowing safety: A new procedure","volume":"2","author":"Langmore","year":"1988","journal-title":"Dysphagia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1007\/s00455-017-9828-9","article-title":"European Society for Swallowing Disorders FEES Accreditation Program for Neurogenic and Geriatric Oropharyngeal Dysphagia","volume":"32","author":"Dziewas","year":"2017","journal-title":"Dysphagia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1044\/2021_AJSLP-20-00348","article-title":"Tutorial on Clinical Practice for Use of the Fiberoptic Endoscopic Evaluation of Swallowing Procedure with Adult Populations: Part 1","volume":"31","author":"Langmore","year":"2022","journal-title":"Am. J. Speech-Lang. Pathol."},{"key":"ref_4","unstructured":"Langmore, S.E. (2001). Endoscopic Evaluation and Treatment of Swallowing Disorders, Thieme Medical Publishers."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1159\/000135652","article-title":"Towards a basic endoscopic assessment of swallowing in acute stroke-development and evaluation of a simple dysphagia score","volume":"26","author":"Dziewas","year":"2008","journal-title":"Cerebrovasc. Dis."},{"key":"ref_6","first-page":"135","article-title":"Pooling score: An endoscopic model for evaluating severity of dysphagia","volume":"28","author":"Farneti","year":"2008","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1159\/000365006","article-title":"The Boston Residue and Clearance Scale: Preliminary reliability and validity testing","volume":"65","author":"Kaneoka","year":"2013","journal-title":"Folia Phoniatr. Logop."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s00455-015-9631-4","article-title":"The Yale Pharyngeal Residue Severity Rating Scale: An Anatomically Defined and Image-Based Tool","volume":"30","author":"Neubauer","year":"2015","journal-title":"Dysphagia"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Speyer, R., Cordier, R., Denman, D., Windsor, C., Krisciunas, G.P., Smithard, D., and Heijnen, B.J. (2022). Development of Two Patient Self-Reported Measures on Functional Health Status (FOD) and Health-Related Quality of Life (QOD) in Adults with Oropharyngeal Dysphagia Using the Delphi Technique. J. Clin. Med., 11.","DOI":"10.3390\/jcm11195920"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s00455-017-9844-9","article-title":"Health-related quality of life and oropharyngeal dysphagia: A systematic review","volume":"33","author":"Jones","year":"2018","journal-title":"Dysphagia"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s00455-014-9584-z","article-title":"Prevalence of oropharyngeal dysphagia in the Netherlands: A telephone survey","volume":"30","author":"Kertscher","year":"2015","journal-title":"Dysphagia"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Banda, K.J., Chu, H., Kang, X.L., Liu, D., Pien, L.-C., Jen, H.-J., Hsiao, S.-T.S., and Chou, K.-R. (2022). Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: A meta-analysis. BMC Geriatr., 22.","DOI":"10.1186\/s12877-022-02960-5"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1186\/s12967-022-03380-0","article-title":"The global prevalence of oropharyngeal dysphagia in different populations: A systematic review and meta-analysis","volume":"20","author":"Rajati","year":"2022","journal-title":"J. Transl. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"527","DOI":"10.3389\/fneur.2022.1000527","article-title":"The prevalence and associated factors of dysphagia in Parkinson\u2019s disease: A systematic review and meta-analysis","volume":"13","author":"Gong","year":"2022","journal-title":"Front. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jocn.2023.01.006","article-title":"Prevalence of dysphagia in patients with multiple sclerosis: A systematic review and meta-analysis","volume":"108","author":"Mirmosayyeb","year":"2023","journal-title":"J. Clin. Neurosci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1111\/dmcn.14316","article-title":"Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: A systematic review and meta-analyses","volume":"61","author":"Speyer","year":"2019","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s00455-021-10283-7","article-title":"White paper by the European society for Swallowing Disorders: Screening and non-instrumental assessment for dysphagia in adults","volume":"37","author":"Speyer","year":"2022","journal-title":"Dysphagia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s00455-018-9918-3","article-title":"Psychometric properties of visuoperceptual measures of videofluoroscopic and fibre-endoscopic evaluations of swallowing: A systematic review","volume":"34","author":"Swan","year":"2019","journal-title":"Dysphagia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1002\/9781119536604.ch8","article-title":"Assessing risk of bias in a randomized trial","volume":"23","author":"Higgins","year":"2019","journal-title":"Cochrane Handb. Syst. Rev. Interv."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1186\/s13063-016-1555-2","article-title":"How to select outcome measurement instruments for outcomes included in a \u201cCore Outcome Set\u201d\u2014A practical guideline","volume":"17","author":"Prinsen","year":"2016","journal-title":"Trials"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1007\/s00455-020-10174-3","article-title":"Visuoperceptual analysis of the videofluoroscopic study of swallowing: An international delphi study","volume":"36","author":"Swan","year":"2021","journal-title":"Dysphagia"},{"key":"ref_22","unstructured":"Terwee, C.B., Prinsen, C., Chiarotto, A., De Vet, H., Bouter, L.M., Alonso, J., Westerman, M.J., Patrick, D.L., and Mokkink, L.B. (2018). COSMIN Methodology for Assessing the Content Validity of PROMs\u2013User Manual, VU University Medical Center."},{"key":"ref_23","first-page":"6","article-title":"COSMIN methodology for systematic reviews of patient-reported outcome measures (PROMs)","volume":"78","author":"Mokkink","year":"2018","journal-title":"User Man."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Boulkedid, R., Abdoul, H., Loustau, M., Sibony, O., and Alberti, C. (2011). Using and reporting the Delphi method for selecting healthcare quality indicators: A systematic review. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0020476"},{"key":"ref_25","unstructured":"Statistics, S. (2020). IBM SPSS Statistics for Windows, Version 27.0, IBM Corp."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jclinepi.2013.12.002","article-title":"Defining consensus: A systematic review recommends methodologic criteria for reporting of Delphi studies","volume":"67","author":"Diamond","year":"2014","journal-title":"J. Clin. Epidemiol."},{"key":"ref_27","first-page":"10","article-title":"The Delphi technique: Making sense of consensus","volume":"12","author":"Hsu","year":"2007","journal-title":"Pract. Assess. Res. Eval."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1136\/jamia.2000.0070416","article-title":"Methods for the design and administration of web-based surveys","volume":"7","author":"Schleyer","year":"2000","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_29","unstructured":"Tanner, D. (2016). Case Studies in Communication Sciences and Disorders, SLACK Incorporated."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/12\/3875\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:49:18Z","timestamp":1760125758000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/12\/3875"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,6]]},"references-count":29,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["jcm12123875"],"URL":"https:\/\/doi.org\/10.3390\/jcm12123875","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,6]]}}}