Author(s): Wallace KL, Middleton S, Cook IJ
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Abstract BACKGROUND & AIMS: The aim of this study was to develop and evaluate the validity and reliability of a self-report inventory to measure symptomatic severity of oral-pharyngeal dysphagia. METHODS: Test-retest reliability and face, content, and construct validity of a prototype visual analogue scale inventory were assessed in 45 patients who had stable, neuromyogenic dysphagia. RESULTS: Normalized scores varied over time by -0.5\% +/- 17.6\% (95\% confidence interval, -9.2\% to 8.2\%). Factor analysis identified a single factor (dysphagia), to which 18 of 19 questions contributed significantly, that accounted for 56\% of total variance (P < 0.0001). After deletion of 2 questions with poor face validity and patient compliance, this proportion increased to 59\%; mean test-retest change was -2\% (95\% confidence interval, -11\% to 7\%); and total score correlated highly with an independent global assessment severity score (r = 0.7; P < 0.0001). A mean 70\% reduction in score (P < 0.0001) was observed after surgery in patients with Zenker's diverticulum (discriminant validity). CONCLUSIONS: Applied to patients with neuromyogenic dysphagia, the 17-question inventory shows strong test-retest reliability over 2 weeks as well as face, content, and construct validity. Discriminant validity (responsiveness) has been demonstrated in a population with a correctable, structural cricopharyngeal disorder. Responsiveness of the instrument to treatment in neuromyogenic dysphagia remains to be quantified.
This article was published in Gastroenterology
and referenced in International Journal of Physical Medicine & Rehabilitation