The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Steven B. Leder - One of the best experts on this subject based on the ideXlab platform.
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Pharyngeal Residue Severity Rating Scales Based on Fiberoptic Endoscopic Evaluation of Swallowing: A Systematic Review
Dysphagia, 2016Co-Authors: Paul D. Neubauer, Denise P. Hersey, Steven B. LederAbstract:Identification of pharyngeal residue Severity located in the valleculae and pyriform sinuses has always been a primary goal during fiberoptic endoscopic evaluation of swallowing (FEES). Pharyngeal residue is a clinical sign of potential prandial aspiration making an accurate description of its Severity an important but difficult challenge. A reliable, validated, and generalizable pharyngeal residue Severity Rating scale for FEES would be beneficial. A systematic review of the published English language literature since 1995 was conducted to determine the quality of existing pharyngeal residue Severity Rating scales based on FEES. Databases were searched using controlled vocabulary words and synonymous free text words for topics of interest (deglutition disorders, pharyngeal residue, endoscopy, videofluoroscopy, fiberoptic technology, aspiration, etc.) and outcomes of interest (scores, scales, grades, tests, FEES, etc.). Search strategies were adjusted for syntax appropriate for each database/platform. Data sources included MEDLINE (OvidSP 1946 – April Week 3 2015), Embase (OvidSP 1974 – 2015 April 20), Scopus (Elsevier), and the unindexed material in PubMed (NLM/NIH) were searched for relevant articles. Supplementary efforts to identify studies included checking reference lists of articles retrieved. Scales were compared using qualitative properties (sample size, Severity definitions, number of raters, and raters’ experience and training) and psychometric analyses (randomization, intra- and inter-rater reliability, and construct validity). Seven articles describing pharyngeal residue Severity Rating scales met inclusion criteria. Six of seven scales had insufficient data to support their use as evidenced by methodological weaknesses with both qualitative properties and psychometric analyses. There is a need for qualitative and psychometrically reliable, validated, and generalizable pharyngeal residue Severity Rating scales that are anatomically specific, image-based, and easily learned by both novice and experienced clinicians. Only the Yale Pharyngeal Residue Severity Rating Scale, an anatomically defined and image-based tool, met all qualitative and psychometric criteria necessary for a valid, reliable, and generalizable vallecula and pyriform sinus Severity Rating scale based on FEES.
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really how easy is it to use the yale pharyngeal residue Severity Rating scale
2016Co-Authors: Steven B. Leder, Paul D. NeubauerAbstract:Objectives: To determine reliability of pharyngeal residue Severity Ratings with naive raters using the Yale Pharyngeal Residue Severity Rating Scale images.
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a systematic literature review of pharyngeal residue Severity Rating scales based on fiberoptic endoscopic evaluation of swallowing
2016Co-Authors: Steven B. Leder, Paul D. NeubauerAbstract:Objectives: Identification of pharyngeal residue Severity located in the valleculae and pyriform sinuses has always been a primary goal during fiberoptic endoscopic evaluation of swallowing (FEES). Pharyngeal residue is a clinical sign of potential prandial aspiration making an accurate description of its Severity an important but difficult challenge. A reliable, validated, and generalizable pharyngeal residue Severity Rating scale for FEES would be beneficial. A systematic review of the published English language literature since 1995 was conducted to determine the quality of existing pharyngeal residue Severity Rating scales based on FEES.
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The Yale Pharyngeal Residue Severity Rating Scale: An Anatomically Defined and Image-Based Tool
Dysphagia, 2015Co-Authors: Paul D. Neubauer, Alfred W. Rademaker, Steven B. LederAbstract:The Yale Pharyngeal Residue Severity Rating Scale was developed, standardized, and validated to provide reliable, anatomically defined, and image-based assessment of post-swallow pharyngeal residue Severity as observed during fiberoptic endoscopic evaluation of swallowing (FEES). It is a five-point ordinal Rating scale based on residue location (vallecula and pyriform sinus) and amount (none, trace, mild, moderate, and severe). Two expert judges reviewed a total of 261 FEES evaluations and selected a no residue exemplar and three exemplars each of trace, mild, moderate, and severe vallecula and pyriform sinus residue. Hard-copy color images of the no residue, 12 vallecula, and 12 pyriform sinus exemplars were randomized by residue location for hierarchical categorization by 20 raters with a mean of 8.3 years of experience (range 2–27 years) performing and interpreting FEES. Severity Ratings for all images were performed by the same 20 raters, 2 weeks apart, and with the order of image presentations randomized. Intra-rater test–retest reliability, inter-rater reliability, and construct validity were determined by pooled multi-category multi-rater kappa statistics. Residue Ratings were excellent for intra-rater reliability for vallecula (kappa = 0.957 ± 0.014) and pyriform sinus (kappa = 0.854 ± 0.021); very good to excellent for inter-rater reliability for vallecula (kappa = 0.868 ± 0.011) and pyriform sinus (kappa = 0.751 ± 0.011); and excellent for validity for vallecula (kappa = 0.951 ± 0.014) and pyriform sinus (kappa = 0.908 ± 0.017). Clinical uses include accurate classification of vallecula and pyriform sinus residue Severity patterns as none, trace, mild, moderate, or severe for diagnostic purposes, determination of functional therapeutic change, and precise dissemination of shared information. Scientific uses include tracking outcome measures, demonstRating efficacy of interventions to reduce pharyngeal residue, investigating morbidity and mortality in relation to pharyngeal residue Severity, and improving training and accuracy of FEES interpretation by students and clinicians. The Yale Pharyngeal Residue Severity Rating Scale is a reliable, validated, anatomically defined, and image-based tool to determine residue location and Severity based on FEES.
Paul D. Neubauer - One of the best experts on this subject based on the ideXlab platform.
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Pharyngeal Residue Severity Rating Scales Based on Fiberoptic Endoscopic Evaluation of Swallowing: A Systematic Review
Dysphagia, 2016Co-Authors: Paul D. Neubauer, Denise P. Hersey, Steven B. LederAbstract:Identification of pharyngeal residue Severity located in the valleculae and pyriform sinuses has always been a primary goal during fiberoptic endoscopic evaluation of swallowing (FEES). Pharyngeal residue is a clinical sign of potential prandial aspiration making an accurate description of its Severity an important but difficult challenge. A reliable, validated, and generalizable pharyngeal residue Severity Rating scale for FEES would be beneficial. A systematic review of the published English language literature since 1995 was conducted to determine the quality of existing pharyngeal residue Severity Rating scales based on FEES. Databases were searched using controlled vocabulary words and synonymous free text words for topics of interest (deglutition disorders, pharyngeal residue, endoscopy, videofluoroscopy, fiberoptic technology, aspiration, etc.) and outcomes of interest (scores, scales, grades, tests, FEES, etc.). Search strategies were adjusted for syntax appropriate for each database/platform. Data sources included MEDLINE (OvidSP 1946 – April Week 3 2015), Embase (OvidSP 1974 – 2015 April 20), Scopus (Elsevier), and the unindexed material in PubMed (NLM/NIH) were searched for relevant articles. Supplementary efforts to identify studies included checking reference lists of articles retrieved. Scales were compared using qualitative properties (sample size, Severity definitions, number of raters, and raters’ experience and training) and psychometric analyses (randomization, intra- and inter-rater reliability, and construct validity). Seven articles describing pharyngeal residue Severity Rating scales met inclusion criteria. Six of seven scales had insufficient data to support their use as evidenced by methodological weaknesses with both qualitative properties and psychometric analyses. There is a need for qualitative and psychometrically reliable, validated, and generalizable pharyngeal residue Severity Rating scales that are anatomically specific, image-based, and easily learned by both novice and experienced clinicians. Only the Yale Pharyngeal Residue Severity Rating Scale, an anatomically defined and image-based tool, met all qualitative and psychometric criteria necessary for a valid, reliable, and generalizable vallecula and pyriform sinus Severity Rating scale based on FEES.
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really how easy is it to use the yale pharyngeal residue Severity Rating scale
2016Co-Authors: Steven B. Leder, Paul D. NeubauerAbstract:Objectives: To determine reliability of pharyngeal residue Severity Ratings with naive raters using the Yale Pharyngeal Residue Severity Rating Scale images.
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a systematic literature review of pharyngeal residue Severity Rating scales based on fiberoptic endoscopic evaluation of swallowing
2016Co-Authors: Steven B. Leder, Paul D. NeubauerAbstract:Objectives: Identification of pharyngeal residue Severity located in the valleculae and pyriform sinuses has always been a primary goal during fiberoptic endoscopic evaluation of swallowing (FEES). Pharyngeal residue is a clinical sign of potential prandial aspiration making an accurate description of its Severity an important but difficult challenge. A reliable, validated, and generalizable pharyngeal residue Severity Rating scale for FEES would be beneficial. A systematic review of the published English language literature since 1995 was conducted to determine the quality of existing pharyngeal residue Severity Rating scales based on FEES.
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The Yale Pharyngeal Residue Severity Rating Scale: An Anatomically Defined and Image-Based Tool
Dysphagia, 2015Co-Authors: Paul D. Neubauer, Alfred W. Rademaker, Steven B. LederAbstract:The Yale Pharyngeal Residue Severity Rating Scale was developed, standardized, and validated to provide reliable, anatomically defined, and image-based assessment of post-swallow pharyngeal residue Severity as observed during fiberoptic endoscopic evaluation of swallowing (FEES). It is a five-point ordinal Rating scale based on residue location (vallecula and pyriform sinus) and amount (none, trace, mild, moderate, and severe). Two expert judges reviewed a total of 261 FEES evaluations and selected a no residue exemplar and three exemplars each of trace, mild, moderate, and severe vallecula and pyriform sinus residue. Hard-copy color images of the no residue, 12 vallecula, and 12 pyriform sinus exemplars were randomized by residue location for hierarchical categorization by 20 raters with a mean of 8.3 years of experience (range 2–27 years) performing and interpreting FEES. Severity Ratings for all images were performed by the same 20 raters, 2 weeks apart, and with the order of image presentations randomized. Intra-rater test–retest reliability, inter-rater reliability, and construct validity were determined by pooled multi-category multi-rater kappa statistics. Residue Ratings were excellent for intra-rater reliability for vallecula (kappa = 0.957 ± 0.014) and pyriform sinus (kappa = 0.854 ± 0.021); very good to excellent for inter-rater reliability for vallecula (kappa = 0.868 ± 0.011) and pyriform sinus (kappa = 0.751 ± 0.011); and excellent for validity for vallecula (kappa = 0.951 ± 0.014) and pyriform sinus (kappa = 0.908 ± 0.017). Clinical uses include accurate classification of vallecula and pyriform sinus residue Severity patterns as none, trace, mild, moderate, or severe for diagnostic purposes, determination of functional therapeutic change, and precise dissemination of shared information. Scientific uses include tracking outcome measures, demonstRating efficacy of interventions to reduce pharyngeal residue, investigating morbidity and mortality in relation to pharyngeal residue Severity, and improving training and accuracy of FEES interpretation by students and clinicians. The Yale Pharyngeal Residue Severity Rating Scale is a reliable, validated, anatomically defined, and image-based tool to determine residue location and Severity based on FEES.
Scott L Gottlieb - One of the best experts on this subject based on the ideXlab platform.
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the wrinkle Severity Rating scale a validation study
American Journal of Clinical Dermatology, 2004Co-Authors: Doris Day, Curt M Littler, Richard W Swift, Scott L GottliebAbstract:Background: Patient satisfaction is the most important outcome in facial aesthetic surgery. However, the need for evidence-based evaluation of aesthetic procedures dictates the use of more objective and quantitative measures of treatment outcome. Objective: The present study was undertaken to validate a new clinical outcome instrument, the Wrinkle Severity Rating Scale. Methods: Five clinical investigators were presented with 30 photographic images of the lower face and asked to rate nasolabial fold Severity on each side using the 5-grade Wrinkle Severity Rating Scale (WSRS). Standardized definitions of the five grades were provided to the investigators in visual (photographic) and descriptive formats. To take into account possible facial asymmetry, nasolabial folds on the left and right sides of the face were rated separately. Assessments were conducted independently and were repeated after ≥2 weeks. Results: Intra-observer (test-retest) agreement was 68.7% (left side) and 72.7% (right side); weighted kappa coefficients for the left and right sides were 0.77 and 0.81, respectively. Mean inter-observer agreement (internal consistency) was 67.7% (left side) and 72.3% (right side); weighted kappa coefficients for the left and right sides were 0.75 (95% CI 0.70–0.79) and 0.78 (95% CI 0.72–0.83), respectively. Conclusion: The WSRS is a valid and reliable instrument for quantitative assessment of facial skin folds, with good inter- and intra-observer consistency. By allowing objective and reproducible grading of data, the WSRS should prove a useful clinical tool for assessing the effectiveness of soft-tissue augmentation and other facial contouring procedures.
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the wrinkle Severity Rating scale a validation study
American Journal of Clinical Dermatology, 2004Co-Authors: Doris Day, Curt M Littler, Richard W Swift, Scott L GottliebAbstract:Background: Patient satisfaction is the most important outcome in facial aesthetic surgery. However, the need for evidence-based evaluation of aesthetic procedures dictates the use of more objective and quantitative measures of treatment outcome.
Robert L Findling - One of the best experts on this subject based on the ideXlab platform.
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desvenlafaxine versus placebo in the treatment of children and adolescents with major depressive disorder
Journal of Child and Adolescent Psychopharmacology, 2017Co-Authors: Sarah Atkinson, Sara Ramaker, Richat Abbas, Richard D England, Dalia B Wajsbrot, Shannon Lubaczewski, Robert L FindlingAbstract:Abstract Objective: To evaluate the short-term efficacy and safety of desvenlafaxine versus placebo in the treatment of children and adolescents with major depressive disorder (MDD). Methods: Outpatient children (7–11 years) and adolescents (12–17 years) who met DSM-IV-TR criteria for MDD and had screening and baseline Children's Depression Rating Scale-Revised (CDRS-R) total scores >40 were randomly assigned to 8 weeks of treatment with placebo, low exposure desvenlafaxine (20, 30, or 35 mg/day based on baseline weight), or higher exposure desvenlafaxine (25, 35, or 50 mg/day based on baseline weight). The primary efficacy endpoint was change from baseline in CDRS-R total score at week 8, analyzed using a mixed-effects model for repeated measures. Secondary efficacy assessments included Clinical Global Impressions-Severity and Clinical Global Impressions-Improvement scales. Safety assessments included adverse events and the Columbia-Suicide Severity Rating Scale. Results: The safety population included 3...
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a 6 month open label extension study of vortioxetine in pediatric patients with depressive or anxiety disorders
Journal of Child and Adolescent Psychopharmacology, 2017Co-Authors: Robert L Findling, Adelaide S Robb, Melissa P Delbello, Michael Huss, Nora K Mcnamara, Elias H Sarkis, Russell E Scheffer, Lis H Poulsen, Grace Chen, Ole LemmingAbstract:Abstract Objectives: In this 6-month open-label extension (OLE) of NCT01491035 (a 14-day, open-label, pharmacokinetic/safety lead-in study), the long-term safety and tolerability of vortioxetine (5–20 mg/day) were investigated in children and adolescents with a DSM-IV-TR™ diagnosis of depressive or anxiety disorder in the United States or Germany. The study also was designed to provide data to inform dose selection and titration in future pediatric studies with vortioxetine. Methods: Safety evaluations included spontaneously reported adverse events (AEs), the Columbia Suicide Severity Rating Scale (C-SSRS), and the Pediatric Adverse Events Rating Scale (PAERS; clinician administered). Clinical effectiveness was determined by Clinical Global Impressions. Comorbid attention-deficit/hyperactivity disorder was permitted, including concomitant use of stimulant medication (US sites only). Results: Of the 47 patients who completed the lead-in period, 41 continued into the OLE. Most patients (n = 39 [95%]) contin...
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pharmacokinetics and tolerability of single ascending doses of desvenlafaxine administered to children and adolescents with major depressive disorder
Journal of Child and Adolescent Psychopharmacology, 2016Co-Authors: Robert L Findling, James Groark, Sara Ramaker, Deborah Chiles, Lingfeng Yang, Karen A Tourian, Alice I NicholsAbstract:Abstract Objective: To investigate the safety and pharmacokinetic profile of ascending doses of desvenlafaxine in children and adolescents with major depressive disorder. Assessment of the effect of desvenlafaxine on depression symptoms was exploratory. Methods: The 8-week, open-label study included an initial 3.5-day inpatient period followed by a 7.5-week outpatient period. Children (7–11 years) received a single desvenlafaxine dose of 10, 25, 50, or 100 mg on day 1; adolescents (12–17 years) received desvenlafaxine 25, 50, 100, or 200 mg/day. Plasma and urine samples were collected over the initial 72-hour inpatient period. Evaluations included treatment-emergent adverse events (TEAEs), physical examinations (including Tanner Staging), vital signs, laboratory assessments, 12-lead electrocardiogram, Columbia-Suicide Severity Rating Scale, and the Children's Depression Rating Scale-Revised (CDRS-R). Results: In all, 29 children and 30 adolescents took at least one dose of desvenlafaxine and were included...
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safety and tolerability of desvenlafaxine in children and adolescents with major depressive disorder
Journal of Child and Adolescent Psychopharmacology, 2014Co-Authors: Robert L Findling, James Groark, Sara Ramaker, Deborah Chiles, Lingfeng Yang, Karen A TourianAbstract:Abstract Objective: The purpose of this study was to assess long-term safety and tolerability of desvenlafaxine (administered as desvenlafaxine succinate) in children and adolescents with major depressive disorder (MDD). Methods: An 8 week, multicenter, open-label, fixed-dose study of children (ages 7–11 years) and adolescents (ages 12–17 years) with MDD was followed by a 6 month, flexible-dose extension study. Patients were administered desvenlafaxine 10–100 mg/day (children) or 25–200 mg/day (adolescents) for a total of 8 months. Treatment-emergent adverse events (AEs), withdrawals because of AEs, laboratory tests, vital signs, and the Columbia Suicide-Severity Rating Scale (C-SSRS) were collected. Eight month safety results from the lead-in plus extension studies are reported for extension study participants, using lead-in study day −1 as baseline. Results: Forty patients were enrolled in both studies (20 children; 20 adolescents). Of those, four children and three adolescents withdrew because of AEs. ...
Doris Day - One of the best experts on this subject based on the ideXlab platform.
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the wrinkle Severity Rating scale a validation study
American Journal of Clinical Dermatology, 2004Co-Authors: Doris Day, Curt M Littler, Richard W Swift, Scott L GottliebAbstract:Background: Patient satisfaction is the most important outcome in facial aesthetic surgery. However, the need for evidence-based evaluation of aesthetic procedures dictates the use of more objective and quantitative measures of treatment outcome. Objective: The present study was undertaken to validate a new clinical outcome instrument, the Wrinkle Severity Rating Scale. Methods: Five clinical investigators were presented with 30 photographic images of the lower face and asked to rate nasolabial fold Severity on each side using the 5-grade Wrinkle Severity Rating Scale (WSRS). Standardized definitions of the five grades were provided to the investigators in visual (photographic) and descriptive formats. To take into account possible facial asymmetry, nasolabial folds on the left and right sides of the face were rated separately. Assessments were conducted independently and were repeated after ≥2 weeks. Results: Intra-observer (test-retest) agreement was 68.7% (left side) and 72.7% (right side); weighted kappa coefficients for the left and right sides were 0.77 and 0.81, respectively. Mean inter-observer agreement (internal consistency) was 67.7% (left side) and 72.3% (right side); weighted kappa coefficients for the left and right sides were 0.75 (95% CI 0.70–0.79) and 0.78 (95% CI 0.72–0.83), respectively. Conclusion: The WSRS is a valid and reliable instrument for quantitative assessment of facial skin folds, with good inter- and intra-observer consistency. By allowing objective and reproducible grading of data, the WSRS should prove a useful clinical tool for assessing the effectiveness of soft-tissue augmentation and other facial contouring procedures.
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the wrinkle Severity Rating scale a validation study
American Journal of Clinical Dermatology, 2004Co-Authors: Doris Day, Curt M Littler, Richard W Swift, Scott L GottliebAbstract:Background: Patient satisfaction is the most important outcome in facial aesthetic surgery. However, the need for evidence-based evaluation of aesthetic procedures dictates the use of more objective and quantitative measures of treatment outcome.