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Development and Validation of a New Screening Test for Dysphagia
´ëÇÑ¿¬ÇÏÀå¾ÖÇÐȸÁö 2013³â 3±Ç 1È£ p.20 ~ p.25
±ÇÂùÇõ(Kwon Chan-Hyuk) - ¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀçÈ°ÀÇÇб³½Ç
Á¤ÀÏ¿µ(Jung Il-Young) - ¿¹»ê±º º¸°Ç¼Ò
Á¤¼¼Èñ(Jung Se-Hee) - ¼¿ïƯº°½Ã º¸¶ó¸Åº´¿ø ÀçÈ°ÀÇÇаú
¿Àº´¸ð(Oh Byung-Mo) - ¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀçÈ°ÀÇÇб³½Ç
ÇÑÅ·û(Han Tai-Ryoon) - ¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀçÈ°ÀÇÇб³½Ç
Abstract
Objective: To develop a new screening test for dysphagia patients with various etiologies.
Method: We investigated 10 widely used screening tests based on previous studies. Contents of the screening tests were summarized into 76 items. By using modified Delphi technique, 23 items showing high average score (£¾3.5) were selected as candidates for the new Clinical Dysphagia Scale (nCDS). A total of 216 dysphagia patients with various etiologies were tested with these items and underwent videofluoroscopic swallowing study (VFSS) simultaneously. We analyzed these data in statistical and clinical aspects to determine which items were more correlated with VFSS findings and which items are more appropriate for the screening test. Content validity was re-evaluated by consensus in an expert meeting. Consequentially, 8 items were selected for the nCDS.
Result: The nCDS included 8 items: swallowing difficulty, structural defect (oral cavity, pharynx, larynx, or esophagus), lip sealing, tongue movement (forward and side to side), saliva swallowing, wet voice or gurgling voice (pre-swallowing), 5 ml water swallowing test (2 times), and laryngeal elevation during swallowing. The sensitivity and specificity of the nCDS score for detecting necessity of food modification were 83.8% and 58.3%, respectively. It was also well correlated with the functional dysphagia scale derived from the VFSS (Pearson¡¯s coefficient 0.525, P £¼0.01).
Conclusion: The nCDS is not only a good screening test for detecting necessity of food modification, but also a good diagnostic tool for evaluation of general swallowing function. Furthermore, it is simply applicable to dysphagic patients with various etiologies.
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Deglutition disorders, Symptom assessment, Sensitivity, Specificity
KMID :
1024320130030010020
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À¯È¿¼º°á°ú(Recomendation)
The nCDS is not only a good screening test for detecting necessity of food modification, but also a good diagnostic. tool for evaluation of general swallowing function