Removable Prosthodontics, Nihon University Graduate School of Dentistry at Matsudo, Chiba, Japan.
Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
J Oral Rehabil. 2019 May;46(5):409-416. doi: 10.1111/joor.12761. Epub 2019 Jan 13.
Several methods exist for objectively evaluating chewing efficiency by using gummy jelly. However, the validity of the subjective visual evaluation of chewing efficiency has not been assessed.
To verify with an epidemiological study, the validity of a visual scoring method using gummy jelly by testing the relationship between masticatory performance (MP) using a fully automatic measuring system and visual score (VS) using a visual scoring method.
Community-dwelling elderly individuals (n = 1234) ≥70 years old participated. One evaluator measured VS consecutively after participants chewed the gummy jelly (ie, actual-VS). The chewed jelly was photographed. Two evaluators used the photograph to measure the gummy jelly (ie, photo-VS). To test the validity of both methods, the correlation between actual-VS and MP and between photo-VS and MP were analysed. Inter-rater reliability between the evaluators of photo-VS was analysed.
Significant correlations existed between actual-VS and MP and between photo-VS and MP (r = 0.86-0.87; P < 0.001). The intra-class correlation coefficient of the inter-rater reliability for photo-VS was very high (0.93; P < 0.001; 95% confidence interval: 0.877-0.953); however, the distribution of photo-VS deviated slightly from the actual-VS. A large coefficient of variation in the MP for low VSs suggested the influence of incomplete comminution, which was not reflected by the VS, and the accidental swallowing of small pieces during chewing.
The VS deviated slightly from the MP calculated using a fully automated method; however, the VS can be utilised for epidemiological surveys with numerous participants.
有几种方法可以使用胶状果冻客观评估咀嚼效率。然而，咀嚼效率的主观视觉评估的有效性尚未得到评估。
通过使用全自动测量系统评估的咀嚼性能（MP）与使用视觉评分法的视觉评分（VS）之间的关系，通过流行病学研究验证使用胶状果冻的视觉评分法的有效性。
共有 1234 名年龄≥70 岁的社区居住的老年人参与了研究。一位评估者在参与者咀嚼胶状果冻后连续测量 VS（即实际-VS）。对咀嚼过的果冻进行拍照。两位评估者使用照片来测量胶状果冻（即照片-VS）。为了测试两种方法的有效性，分析了实际-VS 和 MP 以及照片-VS 和 MP 之间的相关性。还分析了照片-VS 的评估者之间的组内相关系数。
实际-VS 和 MP 以及照片-VS 和 MP 之间存在显著相关性（r = 0.86-0.87；P < 0.001）。照片-VS 的组内相关系数非常高（0.93；P < 0.001；95%置信区间：0.877-0.953）；然而，照片-VS 的分布与实际-VS 略有偏差。VS 较低的 MP 变异系数表明不完全粉碎的影响，这并没有反映在 VS 中，并且在咀嚼过程中会意外吞咽小块。
VS 与使用全自动方法计算的 MP 略有偏差；然而，VS 可用于具有大量参与者的流行病学调查。
