Morawska Joanna, Niebudek-Bogusz Ewa, Stasiołek Mariusz, Świderek-Matysiak Mariola, Pietruszewska Wioletta
Department of Otolaryngology, Head and Neck Oncology; Medical University of Lodz, Lodz, Poland.
Department of Neurology; Medical University of Lodz, Lodz, Poland.
Mult Scler Relat Disord. 2021 Apr;49:102796. doi: 10.1016/j.msard.2021.102796. Epub 2021 Jan 26.
Speech and voice disorders are among the least well-described clinical manifestations of Multiple Sclerosis (MS) although their estimated prevalence reaches 40-50%. The aim of the present study was adaptation and validation of the Speech Pathology-Specific Questionnaire for Persons with Multiple Sclerosis (SMS) into the Polish language to be used as part of the diagnostic procedure to quantify important speech-related changes and to improve individual tailoring of therapeutic activities.
The study included a total number of 178 participants. The study group consisted of 107 patients diagnosed with Multiple Sclerosis, mean age 42.8±11.6 years and the Control Group were 71 healthy sex and age matched normophonic subjects, mean age 44.2±12.5 years with no neurological symptoms. Translated version of SMS was administered to all participants of the study. Voice Handicap Index (VHI) questionnaire was used for comparison purposes. Test-retest reproducibility, internal consistency, floor and ceiling effects, discriminant validity and construct validity of the Polish SMS were investigated. Preliminary assessment of diagnostic value of SMS was conducted on the basis of the results recorded in duration-related quartiles of the Study Group.
High value of Intraclass Correlation Coefficient (ICC= 0 .930) obtained for the test-retest indicates a good level of reproducibility of the Polish SMS. High Cronbach's alpha (α=0.94) proves the test's good internal consistency. There were no floor and ceiling effects for the SMS test score in the Study Group and they were negligible in the Control Group. A significant difference in mean SMS total scores between patients and controls (14.22 points vs. 6.06 points) shows discriminant validity of SMS. Similar differences were observed for all the subscales of the test (in t test: p<0.001). A statistically significant correlation was found for the SMS score and its all subscales, as well as between all the subscales of the test proving good construct validity of the test. Similarly, statistically significant correlations were observed for the total score of SMS and VHI (r=.817, p <0.001) as well as between the particular subscales of SMS test and the subscales of VHI. There was a statistically significant difference in the mean total score of SMS in the distinguished quartiles of the Study Group with the highest values (20 points) recorded in the group of patients suffering from MS for over 15 years.
The psychometric properties of the Polish version of Speech Pathology-Specific Questionnaire indicate that it is a valid patient-reported outcome measure suitable for the assessment of speech-language pathology aspects on the population of Multiple Sclerosis patients and can be used as an complementary diagnostic tool in clinical practice.
言语和嗓音障碍是多发性硬化症（MS）中描述最少的临床表现之一，尽管其估计患病率达到40%-50%。本研究的目的是将多发性硬化症患者专用言语病理学问卷（SMS）改编并验证为波兰语，用作诊断程序的一部分，以量化重要的言语相关变化，并改善治疗活动的个性化定制。
该研究共纳入178名参与者。研究组由107名被诊断为多发性硬化症的患者组成，平均年龄42.8±11.6岁，对照组为71名年龄和性别匹配的健康、嗓音正常的受试者，平均年龄44.2±12.5岁，无神经症状。将SMS的翻译版本施用于研究的所有参与者。使用嗓音障碍指数（VHI）问卷进行比较。研究了波兰语SMS的重测信度、内部一致性、地板效应和天花板效应、判别效度和结构效度。根据研究组与持续时间相关的四分位数中记录的结果，对SMS的诊断价值进行了初步评估。
重测得到的组内相关系数（ICC = 0.930）较高，表明波兰语SMS具有良好的重测信度。克朗巴哈系数较高（α = 0.94）证明该测试具有良好的内部一致性。研究组中SMS测试分数没有地板效应和天花板效应，对照组中的效应可忽略不计。患者和对照组之间SMS总分的显著差异（14.22分对6.06分）表明SMS具有判别效度。在测试的所有子量表中也观察到类似差异（t检验：p<0.001）。发现SMS分数与其所有子量表之间以及测试的所有子量表之间存在统计学显著相关性，证明该测试具有良好的结构效度。同样，观察到SMS总分与VHI之间存在统计学显著相关性（r = 0.817，p <0.001），以及SMS测试的特定子量表与VHI子量表之间存在相关性。在研究组的不同四分位数中，SMS的平均总分存在统计学显著差异，病程超过15年的多发性硬化症患者组记录到的分数最高（20分）。
波兰语版言语病理学专用问卷的心理测量特性表明，它是一种有效的患者报告结局测量工具，适用于评估多发性硬化症患者群体的言语语言病理学方面，可作为临床实践中的辅助诊断工具。
