Steele Catriona M, Grace-Martin Karen
Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, 12th Floor, Toronto, ON, M5G 2A2, Canada.
Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON, M5G 1V7, Canada.
Dysphagia. 2017 Oct;32(5):601-616. doi: 10.1007/s00455-017-9809-z. Epub 2017 May 22.
The 8-point Penetration-Aspiration Scale (PAS) was introduced to the field of dysphagia in 1996 and has become the standard method used by both clinicians and researchers to describe and measure the severity of airway invasion during swallowing. In this article, we review the properties of the scale and explore what has been learned over 20 years of use regarding the construct validity, ordinality, intervality, score distribution, and sensitivity of the PAS to change. We propose that a categorical revision of the PAS into four levels of increasing physiological severity would be appropriate. The article concludes with a discussion of common errors made in the statistical analysis of the PAS, proposing that frequency distributions and ordinal logistic regression approaches are most appropriate given the properties of the scale. A hypothetical dataset is included to illustrate both the problems and strengths of different statistical approaches.
8分吞咽穿透-误吸量表（PAS）于1996年被引入吞咽困难领域，已成为临床医生和研究人员用于描述和测量吞咽过程中气道侵犯严重程度的标准方法。在本文中，我们回顾了该量表的特性，并探讨了在20多年的使用中关于PAS的结构效度、有序性、区间性、分数分布以及对变化的敏感性所学到的内容。我们建议将PAS进行分类修订，分为生理严重程度递增的四个等级是合适的。本文最后讨论了PAS统计分析中常见的错误，提出鉴于该量表的特性，频率分布和有序逻辑回归方法最为合适。文中包含一个假设数据集，以说明不同统计方法的问题和优势。
