Reliability of Speech Variables and Speech-Related Quality Indicators in the Swedish Cleft Lip and Palate Registry

• Published in: The Cleft palate-craniofacial journal Vol. 57; no. 6; pp. 715 - 722
• Main Authors: Brunnegård, Karin, Hagberg, Emilie, Havstam, Christina, Okhiria, Åsa, Klintö, Kristina
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-06-2020; SAGE PUBLICATIONS, INC
• Subjects: Agreements; Birth defects; Child, Preschool; Children & youth; Cleft Lip; cleft lip and palate; Cleft Palate; Clinical Medicine; Dentistry; Errors; Humans; Indicators and Reagents; Klinisk medicin; Medical and Health Sciences; Medicin och hälsovetenskap; Oto-rhino-laryngologi; Oto-rino-laryngologi; Otorhinolaryngology; Quality; Quality control; quality indicators; quality registry; Registries; reliability; Reproducibility of Results; Retrospective Studies; Speech; speech variables; Sweden; Velopharyngeal Insufficiency; Sweden; cleft lip and palate; quality indicators; quality registry; reliability; speech variables
• ISSN: 1055-6656; 1545-1569; 1545-1569
• DOI: 10.1177/1055665619894497

Objective:
To assess the reliability of speech variables and speech-related quality indicators in the Swedish quality registry for cleft lip and palate (CLP).
Design:
Retrospective study.
Setting:
Primary care university hospitals.
Participants:
Fifty-two 5-year-old children with unilateral CLP and 41 with bilateral CLP.
Main Outcome Measures:
Registry data for “percent nonoral errors” and “perceived velopharyngeal competence” (VPC) were compared to reassessments by 4 independent judges based on audio recordings. Interjudge agreement for “percent consonants correct” (PCC) and the reliability of 3 quality indicators were also assessed. Agreement was calculated with single measures intraclass correlation coefficient (ICC) for articulation outcomes, quadratic weighted κ and ICC for VPC, and percentage agreement and κ for quality indicators.
Results:
When the agreement between registry data and the judges’ reassessments was assessed, the ICC was 0.79 for percent nonoral errors. For VPC, the κ coefficient was 0.66 to 0.75 and the ICC was 0.73. Interjudge agreement for PCC calculated with ICC was 0.85. For the quality indicator “proportion of children with ≥86% correct consonants,” all 4 judges were in agreement for 72% of the cases. For “proportion of children without nonoral speech errors” and “proportion of children with competent or marginally incompetent velopharyngeal function,” the agreement between registry data and the 4 judges was 89% and 85%, respectively.
Conclusions:
The results indicate that registry data on PCC, percent nonoral errors, VPC, and the quality indicators “proportion of children without nonoral speech errors” and “proportion of children with competent or marginally incompetent velopharyngeal function” are reliable.