Petersson Kerstin, Finizia Caterina, Pauli Nina, Tuomi Lisa
Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, SE-41345, Sweden.
Dysphagia. 2024 Sep 27. doi: 10.1007/s00455-024-10759-2.
In the head and neck cancer (HNC) population around 45% suffer from chronic swallowing difficulties after cancer treatment. Previously a measure for flexible endoscopic evaluation of swallowing (FEES) where swallowing efficiency, safety and overall ability is evaluated within the same framework has been lacking. The Dynamic Imaging Grade of Swallowing Toxicity for FEES (DIGEST-FEES) was developed in 2021 and provides such a measure for patients with HNC. The aim of this study was to translate and validate the DIGEST-FEES into Swedish (Sw-DIGEST-FEES). A translation of the protocol to Swedish was done through forward-backward translation. Two raters rated eighty-nine FEES recordings according to the Sw-DIGEST-FEES and five reference measures of swallowing ability: Yale Pharyngeal Residue Severity Rating Scale, Swallowing Performance Scale, Murray Secretion Scale, MD Anderson Dysphagia Inventory and Penetration Aspiration Scale. Intra- and interrater reliability was analyzed. Construct validity was evaluated by correlating the Sw-DIGEST-FEES ratings to the reference measures. A priori hypothesis was that the correlations would correspond to those of the reference measures included in the original English version. The Sw-DIGEST-FEES demonstrated retained psychometric properties. Construct validity was good. 79% of correlations to the reference measures were equal to or stronger than those in the original development. Inter-rater agreement of the Sw-DIGEST-FEES ranged from substantial to almost perfect (0.76-0.81). Intra-rater reliability was in general almost perfect (0.8-1). The Sw-DIGEST-FEES can be considered a valid and reliable protocol for use in evaluation of swallowing function in HNC patients.
在头颈癌（HNC）患者群体中，约45%的患者在癌症治疗后会出现慢性吞咽困难。此前，一直缺乏一种在同一框架内评估吞咽效率、安全性和整体能力的柔性内镜吞咽评估（FEES）方法。吞咽毒性动态成像分级法（DIGEST-FEES）于2021年开发，为头颈癌患者提供了这样一种评估方法。本研究的目的是将DIGEST-FEES翻译成瑞典语（Sw-DIGEST-FEES）并进行验证。通过前后翻译将该方案翻译成瑞典语。两名评估者根据Sw-DIGEST-FEES以及五项吞咽能力参考指标对89份FEES记录进行评分：耶鲁咽残留严重程度评定量表、吞咽表现量表、默里分泌物量表、MD安德森吞咽困难量表和渗透误吸量表。分析了评估者内和评估者间的信度。通过将Sw-DIGEST-FEES评分与参考指标进行关联来评估结构效度。先验假设是这些相关性将与原始英文版中包含的参考指标的相关性一致。Sw-DIGEST-FEES显示出保留的心理测量特性。结构效度良好。与参考指标的相关性中有79%等于或强于原始开发中的相关性。Sw-DIGEST-FEES的评估者间一致性范围从实质性到几乎完美（0.76 - 0.81）。评估者内信度总体上几乎完美（0.8 - 1）。Sw-DIGEST-FEES可被认为是用于评估头颈癌患者吞咽功能的有效且可靠的方案。
