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用于评估眼咽型肌营养不良吞咽困难的吞咽直径测量属性

Measurement Properties of the Dysphagiameter for the Assessment of Dysphagia in Oculopharyngeal Muscular Dystrophy.

作者信息

Côté Claudia, Brais Bernard, Batcho Charles Sèbiyo, Brisson Jean-Denis, Youssof Sarah, Sogbossi Emmanuel Sègnon, Gagnon Cynthia

机构信息

Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001 12e avenue Nord, Sherbrooke, QC, J1H 5N4, Canada.

Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Clinique des maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean 2230 de l'Hôpital 7e étage C.P. 1200, Saguenay, QC, G7X 7X2, Canada.

出版信息

Dysphagia. 2024 Dec 21. doi: 10.1007/s00455-024-10791-2.

Abstract

Oculopharyngeal muscular dystrophy (OPMD) is a rare late-onset muscle disease with progressive dysphagia as a major symptom. The Dysphagiameter is a newly developed patient-reported outcome measure (PROM) to assess the severity of dysphagia and its impact in patients with OPMD. This article reports on item reduction and a first assessment of the Dysphagiameter's psychometrics properties, in a French and English-speaking population of individuals with OPMD. Classical test theory and Rasch model were used for item reduction and scoring (n = 162). Construct validity was assessed using the time to drink 80 ml of cold water and the Sydney Swallow Questionnaire (SSQ) (n = 40). Part A of the final PROM resulted in a 21-item scale assessing the capacity to swallow foods of various textures and a 3-item scale assessing the capacity to swallow liquids (Cronbach Alpha = 0.90); the hierarchical structure of the 21-item scale was confirmed with a Rasch analysis (Person separation index = 0.95). Part B resulted in a 6 item-scale assessing the impact on mealtime and a 2-item scale assessing discomfort related to thick saliva (Alpha Cronbach = 0.91 and 0.79). Convergent validity was demonstrated by significant correlations with the SSQ. Known-group validity was supported by the ability of the Dysphagiameter to detect significant differences according to the severity of dysphagia. In summary, the Dysphagiameter-OPMD, a newly developed PROM, exhibits strong psychometric properties and holds promise as a valuable tool for assessing the severity of dysphagia and its impact on individuals with OPMD.

摘要

眼咽型肌营养不良症(OPMD)是一种罕见的迟发性肌肉疾病,主要症状为进行性吞咽困难。吞咽直径测量仪是一种新开发的患者报告结局指标(PROM),用于评估OPMD患者吞咽困难的严重程度及其影响。本文报告了在法语和英语背景的OPMD患者群体中进行的项目缩减以及对吞咽直径测量仪心理测量学特性的首次评估。使用经典测试理论和拉施模型进行项目缩减和评分(n = 162)。使用饮用80毫升冷水的时间和悉尼吞咽问卷(SSQ)评估结构效度(n = 40)。最终PROM的A部分产生了一个21项量表,用于评估吞咽各种质地食物的能力,以及一个3项量表,用于评估吞咽液体的能力(克朗巴哈α系数 = 0.90);通过拉施分析确认了21项量表的层次结构(个人分离指数 = 0.95)。B部分产生了一个6项量表,用于评估对用餐时间的影响,以及一个2项量表,用于评估与浓稠唾液相关的不适(克朗巴哈α系数分别为0.91和0.79)。与SSQ的显著相关性证明了收敛效度。吞咽直径测量仪能够根据吞咽困难的严重程度检测出显著差异,从而支持了已知群体效度。总之,新开发的PROM——吞咽直径测量仪-OPMD具有强大的心理测量学特性,有望成为评估吞咽困难严重程度及其对OPMD患者影响的有价值工具。

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