, Volume 34, Issue 1, pp 2–33 | Cite as

Psychometric Properties of Visuoperceptual Measures of Videofluoroscopic and Fibre-Endoscopic Evaluations of Swallowing: A Systematic Review

  • Katina SwanEmail author
  • Reinie Cordier
  • Ted Brown
  • Renée Speyer
Review Article


Fibreoptic Endoscopic Evaluation of Swallowing (FEES) and Videofluoroscopic Swallow Studies (VFSS) are instrumental assessments of dysphagia which provide videos of the internal structures of swallowing. They are commonly regarded as ‘gold-standard’ assessments; however, there is no consensus regarding a gold-standard measure to analyse the video recordings that they produce. Measures require sound psychometric properties to be suitable for clinical or research purposes. To date, no review of psychometric properties of FEES and VFSS measures has been undertaken or formally reported. This review assessed the quality of the psychometric properties of visuoperceptual measures of FEES and VFSS. Electronic databases were searched for studies reporting on psychometric qualities of visuoperceptual measures which are used to analyse recordings from FEES and VFSS. All dates until February 2017 were included. The Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist was used to evaluate the methodical quality of studies. The measures’ overall quality was then assessed by combining COSMIN ratings with quality criteria. Forty-five studies, reporting on 39 measures, met the inclusion criteria for this review. Data about the measures’ psychometric properties were very limited. Twenty-one measures had information available about reliability only, while 18 had information on up to five of the possible nine psychometric properties categorised within the COSMIN framework. The majority of the FEES and VFSS measures’ psychometric properties were rated as ‘indeterminate’ overall, due to the small number of studies, issues with design, statistical analyses, and reporting practices of extant studies. There is insufficient evidence to recommend any individual measure included in this review as valid and reliable to interpret VFSS and FEES recordings. Further research, which utilises robust methodological design and reporting, is needed to examine the psychometric properties of measures for FEES and VFSS.


Videofluoroscopy Fibre-endoscopic evaluations of swallowing Dysphagia Deglutition Measure Psychometrics 



The first author completed this study as part of the requirements for the completion of a PhD under supervision of Associate Profesor Reinie Cordier, Associate Profesor Ted Brown, and Profesor Renée Speyer. The authors wish to acknowledge Curtin University and the Australian Federal Government for the Curtin University Postgraduate Scholarship (CUPS) and the Australian Government Research Training Program Stipend Scholarship. The authors of the study would like to thank Ms Amy Hodges, who assisted with abstract screening and instrument ratings.

Author Contributions

The authors KS, RC, TB and RS have conceived, designed, and performed the experiment, contributed materials/analysis tools and to the writing of the paper. The authors KS and RS have analysed the data.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors.

Supplementary material

455_2018_9918_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 21 kb)


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Occupational Therapy and Social WorkCurtin UniversityPerthAustralia
  2. 2.Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health SciencesMonash University – Peninsula CampusFrankstonAustralia
  3. 3.Department of Special Needs EducationUniversity of OsloOsloNorway
  4. 4.Department of Otorhinolaryngology and Head and Neck SurgeryLeiden University Medical CentreLeidenThe Netherlands

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