Department of Gastroenterology and Hepatology, St George Hospital, Sydney, New South Wales, Australia.
Department of Gastroenterology and Hepatology, Flinders Medical Centre, Adelaide, South Australia, Australia.
Neurogastroenterol Motil. 2024 May;36(5):e14766. doi: 10.1111/nmo.14766. Epub 2024 Feb 23.
Accurate assessment of patient-reported oropharyngeal dysphagia (OPD) is essential to guide appropriate management and evaluate response. The Sydney Swallow Questionnaire (SSQ) is a paper-based 17-item inventory developed and validated to objectively detect risk of OPD. An easy-to-use electronic version with digital output has significant potential in streamlining patient assessment. This study aims to develop and validate an electronic version of the SSQ (eSSQ) against the original paper version.
The English-based paper SSQ was adapted on the online REDcap (Research Electronic Data Capture) platform to be accessible on computer and mobile devices. Patients with OPD and asymptomatic controls completed both electronic and paper versions in randomized order. Patients with stable symptoms then repeated the eSSQ after ≥14 days for test-retest reliability. Paper-based and eSSQs were also collected from an independent cohort for external validation. Agreement of total scores between both versions and eSSQ test-retest reliability were calculated using two-way mixed-effects intra-class correlation coefficient (ICC).
47 dysphagic patients, 32 controls, and 31 patients from an external validation cohort were recruited. The most common underlying etiology was head and neck cancer. Mean eSSQ total score was 789 in dysphagic patients, and 68 in controls. eSSQ had excellent agreement with paper SSQ in total scores among all participants, with ICC 0.97 (95% CI [0.93, 0.98]) in controls, 0.97 (95% CI [0.94, 0.98]) in dysphagic patients and 0.96 (95% CI [0.92, 0.98]) in validation cohort. Test-retest reliability was also excellent (ICC 0.96, 95% CI [0.90, 0.98]).
The newly developed eSSQ shows excellent agreement with the paper version and test-retest reliability. Future applications of its use may allow for more efficient and accessible patient assessment.
准确评估患者报告的口咽吞咽困难（OPD）对于指导适当的管理和评估反应至关重要。悉尼吞咽问卷（SSQ）是一种基于纸张的 17 项清单，用于客观检测 OPD 风险。具有数字输出功能的易于使用的电子版本在简化患者评估方面具有巨大的潜力。本研究旨在开发和验证 SSQ 的电子版本（eSSQ），并与原始纸质版本进行比较。
将基于英语的纸质 SSQ 改编到在线 REDcap（Research Electronic Data Capture）平台上，使其可在计算机和移动设备上使用。OPD 患者和无症状对照者以随机顺序分别完成电子和纸质版本。然后，症状稳定的患者在至少 14 天后重复进行 eSSQ，以评估测试-重测信度。还从独立队列中收集了纸质和电子 SSQ 进行外部验证。使用双向混合效应组内相关系数（ICC）计算两个版本之间的总分一致性和 eSSQ 测试-重测信度。
共招募了 47 例吞咽困难患者、32 例对照者和 31 例来自外部验证队列的患者。最常见的潜在病因是头颈部癌症。吞咽困难患者的平均 eSSQ 总分为 789，对照者为 68。在所有参与者中，eSSQ 与纸质 SSQ 的总分具有极好的一致性，ICC 分别为 0.97（95% CI [0.93，0.98]）（对照者）、0.97（95% CI [0.94，0.98]）（吞咽困难患者）和 0.96（95% CI [0.92，0.98]）（验证队列）。测试-重测信度也非常好（ICC 0.96，95% CI [0.90，0.98]）。
新开发的 eSSQ 与纸质版本具有极好的一致性和测试-重测信度。未来其应用可能会使患者评估更加高效和便捷。
