Chailey Heritage Clinical Services, Sussex Community NHS Trust, Lewes, UK.
Dev Med Child Neurol. 2014 Mar;56(3):245-51. doi: 10.1111/dmcn.12352. Epub 2013 Dec 18.
The aim of this study was to develop a valid classification system to describe eating and drinking ability in people with cerebral palsy (CP), and to test its reliability.
The Eating and Drinking Ability Classification System (EDACS) was developed in four stages in consultation with individuals with CP, parents, and health professionals: Stage 1, drafting informed by literature and clinical experience; Stage 2, modification by nominal groups; Stage 3, refinement in an international Delphi survey; and Stage 4, testing of agreement and reliability between classifications made by speech and language therapists (SaLTs), and between SaLTs and parents.
Seven nominal groups involved 56 participants; 95 people participated in two rounds of the Delphi survey. Using the version of EDACS produced from this process, SaLTs in pairs classified 100 children. The rate of absolute agreement was 78% (kappa=0.72; intraclass correlation coefficient [ICC]=0.93; 95% confidence interval [CI] 0.90-0.95). Any disagreement was only by one level, with one exception. SaLTs and parents classified 48 children. The rate of absolute agreement was 58% (kappa=0.45, ICC=0.86; 95% CI 0.76-0.92). Parents either agreed with SaLTs or rated their children as more able by one level.
The EDACS provides a valid and reliable system for classifying eating and drinking performance of people with CP, for use in both clinical and research contexts.
本研究旨在开发一种有效的分类系统，以描述脑瘫（CP）患者的进食和饮水能力，并对其可靠性进行测试。
采用与 CP 患者、家长和卫生专业人员协商的方式，经过四个阶段制定了进食和饮水能力分类系统（EDACS）：第 1 阶段，根据文献和临床经验起草；第 2 阶段，通过名义小组进行修改；第 3 阶段，在国际 Delphi 调查中进行完善；第 4 阶段，测试言语治疗师（SaLTs）之间、SaLTs 与家长之间分类的一致性和可靠性。
7 个名义小组共涉及 56 名参与者；95 人参加了两轮 Delphi 调查。使用从该过程中产生的 EDACS 版本，SaLTs 对 100 名儿童进行了分类。绝对一致性率为 78%（kappa=0.72；组内相关系数[ICC]=0.93；95%置信区间[CI]0.90-0.95）。任何分歧仅相差一个级别，只有一个例外。SaLTs 和家长对 48 名儿童进行了分类。绝对一致性率为 58%（kappa=0.45，ICC=0.86；95%CI 0.76-0.92）。家长要么与 SaLTs 意见一致，要么将他们的孩子评定为能力高一个级别。
EDACS 为 CP 患者的进食和饮水表现提供了一种有效的分类系统，可用于临床和研究环境。
