Deptartment of Otolaryngology-Head & Neck Surgery, NW Center for Voice & Swallowing, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
Dysphagia. 2023 Oct;38(5):1295-1307. doi: 10.1007/s00455-023-10555-4. Epub 2023 Jan 24.
The Swallow Disturbance Questionnaire (SDQ) is a screening tool developed to identify patients with Parkinson's Disease (PD) in need of objective swallowing evaluation. In a previous investigation, the SDQ did not predict abnormal airway protection on a videofluoroscopic swallowing study (VFSS). This investigation was undertaken to determine whether SDQ scores were more accurate when a global measure was used. The Dynamic Imaging Grade for Swallowing Toxicity (DIGEST) is a validated measure that provides a safety, efficiency, and total severity grade based on VFSS. A secondary analysis was performed using data from 20 patients with PD who had participated in a standardized VFSS protocol. The study sample was predominantly male (80%) with an average age of 71 years, and an average PD duration of 9 years. Using an established cut-off score, participants were subdivided into those with "normal" (n = 10) and "abnormal" SDQ scores (n = 10). Recordings were scored using the DIGEST protocol by two blinded raters who also rated overall dysphagia severity from the VFSS. There was good agreement between the two raters on the DIGEST and strong correlations between DIGEST scores and clinician perceptions of dysphagia severity. Higher SDQ scores were associated with poorer Efficiency on the DIGEST but not Safety or Total scores. Consistent with other PD studies, subjective perceptions of dysphagia were poorly predictive of objective findings on VFSS. There is little information about the validity of the DIGEST for rating neurogenic dysphagia. Our study provides preliminary support for the use of the DIGEST in the PD population.
吞咽障碍问卷 (SDQ) 是一种筛查工具,旨在识别需要进行客观吞咽评估的帕金森病 (PD) 患者。在之前的一项研究中,SDQ 并未预测视频透视吞咽研究 (VFSS) 中异常气道保护。本研究旨在确定使用总体测量时 SDQ 评分是否更准确。吞咽毒性的动态成像分级 (DIGEST) 是一种经过验证的测量方法,它根据 VFSS 提供安全性、效率和总严重程度分级。对 20 名参加标准化 VFSS 方案的 PD 患者的数据进行了二次分析。研究样本主要为男性(80%),平均年龄为 71 岁,PD 平均病程为 9 年。使用既定的截断分数,将参与者分为“正常”(n = 10)和“异常” SDQ 评分(n = 10)。使用 DIGEST 协议对记录进行评分,由两名盲法评分者进行评分,评分者还根据 VFSS 对整体吞咽困难严重程度进行评分。两名评分者在 DIGEST 上的评分具有良好的一致性,并且 DIGEST 评分与临床医生对吞咽困难严重程度的评估之间存在很强的相关性。较高的 SDQ 评分与 DIGEST 上的效率降低相关,但与安全性或总评分无关。与其他 PD 研究一致,主观吞咽困难感知与 VFSS 上的客观发现预测不佳。关于 DIGEST 用于评定神经源性吞咽困难的有效性的信息很少。我们的研究为在 PD 人群中使用 DIGEST 提供了初步支持。
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