Characterizing the Validity of Using VASES to Derive DIGEST-FEES Grades.

1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

Effects of Puree Type and Color on Ratings of Pharyngeal Residue, Penetration, and Aspiration during FEES: A Prospective Study of 37 Dysphagic Outpatient Adults.Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP) · 2025
Trial
Thin Liquid Sip Sizes in Outpatient Adults with Normal and Disordered Swallowing: Modifying Factors and Relationships with Swallowing Safety and Efficiency.Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP) · 2026
Article
Evaluation of effortful swallow in patients with post stroke dysphagia using visual analysis of swallowing efficiency and safety (VASES) protocol.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
Article
Respiratory-Swallow Training and Variable Practice in Parkinson's Disease: A Clinical Trial Pilot Study.Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP) · 2026
Article
Breath-Holding Maneuvers and Airway Closure in Healthy Adults and Parkinson's Disease: Effects of Maneuver Type, Health Status, and Vocal Fold Bowing.Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP) · 2025
Article

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

James A CurtisAerodigestive Innovations Research Lab (AIR), Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, Cornell University, New York, New York, USA.

Lauren Tabor GrayDr. Kiran C. Patel College of Allopathic Medicine, Center for Collaborative Research, NOVA Southeastern University, Fort Lauderdale, Florida, USA.

Loni ArreseDepartment of Speech and Hearing Science, Ohio State University, Columbus, Ohio, USA.

James C BordersLaboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA.

Heather StarmerHOPES Lab, Department of Otolaryngology - Head and Neck Surgery, Stanford University, Palo Alto, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionVisual Analysis of Swallowing Efficiency and Safety (VASES) and Dynamic Imaging Grade of Swallowing Toxicity for Flexible Endoscopic Evaluation of Swallowing (DIGEST-FEES) are two complimentary methods for assessing swallowing during FEES. Whereas VASES is intended to facilitate trial-level ratings of pharyngeal residue, penetration, and aspiration, DIGEST-FEES is intended to facilitate protocol-level impairment grades of swallowing safety and efficiency. The aim of this study was to assess the validity of using VASES to derive DIGEST-FEES impairment grades.

methodsDIGEST-FEES grades were blindly analyzed from 50 FEES - first using the original DIGEST-FEES grading method (n = 50) and then again using a VASES-derived DIGEST-FEES grading method (n = 50). Weighted Kappa (κw) and absolute agreement (%) were used to assess the relationship between the original DIGEST-FEES grades and VASES-derived DIGEST-FEES grades. Spearman's correlations assessed the relationship between VASES-derived DIGEST-FEES grades with measures of construct validity.

resultsSubstantial agreement (κw = 0.76-0.83) was observed between the original and VASES-derived grading methods, with 60-62% of all DIGEST-FEES grades matching exactly, and 92-100% of DIGEST-FEES grades within one grade of each other. Furthermore, the strength of the relationships between VASES-derived DIGEST-FEES grades and measures of construct validity (r = 0.34-0.78) were similar to the strength of the relationships between original DIGEST-FEES grades and the same measures of construct validity (r = 0.34-0.83).

conclusionFindings from this study demonstrate substantial agreement between original and VASES-derived DIGEST-FEES grades. Using VASES to derive DIGEST-FEES also appears to maintain the same level of construct validity established with the original DIGEST-FEES. Therefore, clinicians and researchers may consider using VASES to increase the transparency and standardization of DIGEST-FEES ratings. Future research should seek to replicate these findings and explore the simultaneous use of VASES and DIGEST-FEES in a greater sampling of raters and across other patient populations.

introductionVisual Analysis of Swallowing Efficiency and Safety (VASES) and Dynamic Imaging Grade of Swallowing Toxicity for Flexible Endoscopic Evaluation of Swallowing (DIGEST-FEES) are two complimentary methods for assessing swallowing during FEES. Whereas VASES is intended to facilitate trial-level ratings of pharyngeal residue, penetration, and aspiration, DIGEST-FEES is intended to facilitate protocol-level impairment grades of swallowing safety and efficiency. The aim of this study was to assess the validity of using VASES to derive DIGEST-FEES impairment grades.

methodsDIGEST-FEES grades were blindly analyzed from 50 FEES - first using the original DIGEST-FEES grading method (n = 50) and then again using a VASES-derived DIGEST-FEES grading method (n = 50). Weighted Kappa (κw) and absolute agreement (%) were used to assess the relationship between the original DIGEST-FEES grades and VASES-derived DIGEST-FEES grades. Spearman's correlations assessed the relationship between VASES-derived DIGEST-FEES grades with measures of construct validity.

resultsSubstantial agreement (κw = 0.76-0.83) was observed between the original and VASES-derived grading methods, with 60-62% of all DIGEST-FEES grades matching exactly, and 92-100% of DIGEST-FEES grades within one grade of each other. Furthermore, the strength of the relationships between VASES-derived DIGEST-FEES grades and measures of construct validity (r = 0.34-0.78) were similar to the strength of the relationships between original DIGEST-FEES grades and the same measures of construct validity (r = 0.34-0.83).

conclusionFindings from this study demonstrate substantial agreement between original and VASES-derived DIGEST-FEES grades. Using VASES to derive DIGEST-FEES also appears to maintain the same level of construct validity established with the original DIGEST-FEES. Therefore, clinicians and researchers may consider using VASES to increase the transparency and standardization of DIGEST-FEES ratings. Future research should seek to replicate these findings and explore the simultaneous use of VASES and DIGEST-FEES in a greater sampling of raters and across other patient populations.

Indexed as

DeglutitionDeglutition DisordersFemaleHumansMaleMiddle AgedReproducibility of ResultsDIGEST-FEESDysphagiaFEESSwallowingVASES