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He X, Yang D, Shao J, Wang H, Zhang H. Mapping Dysphagia Research Trends in Community Dwelling Older Adults: A Bibliometric Analysis. J Multidiscip Healthc 2024; 17:3073-3090. [PMID: 38974375 PMCID: PMC11227311 DOI: 10.2147/jmdh.s461046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 06/17/2024] [Indexed: 07/09/2024] Open
Abstract
Background In recent years, research on dysphagia has gained significant traction as one of the key topics of oral health research pertaining to the aged. Numerous academics have studied dysphagia in great detail and have produced numerous excellent scientific research findings. Objective To review the literature regarding dysphagia in community-dwelling older adults and identify the knowledge and trends using bibliometric methods. Methods The literature on dysphagia in older adults in the community was gathered from the Web of Science Core Collection (WoSCC), with inclusion criteria specifying English-language publications. The retrieval deadline was November 28, 2022. We extracted the following data: title, year, abstract, author, keywords, institution, and cited literature, and used CiteSpace (version 6.1.R3) to visualize the data through the knowledge map, burst keyword analysis, cluster analysis, and collaborative network analysis. Results A total of 979 articles and reviews were retrieved. Regarding productivity, the top 2 countries were the United States (n =239) and Japan (n =236). Hidetaka Wakabayashi (n =26) was one of the most prolific writers. The first paper in the frequency ranking of references cited was a white paper: European Society for Swallowing Disorders and European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome (n =53). "Prevalence" (n =173), "risk factor" (n =119), and "aspiration pneumonia" (n =108) were the most frequently occurring keywords (excluding defining nouns). The study identified reliability, tongue pressure, home discharge, and swallowing function as research hotspots from 2020 to 2022. Conclusion Prevalence, risk factors, and pneumonia are significant areas of study. Tongue pressure and sarcopenia are research hotspots and potential targets. In the future, research on dysphagia needs to refine strategies for prevention and control, as well as provide tertiary preventative services.
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Affiliation(s)
- Xiaona He
- Department of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, People’s Republic of China
| | - Dan Yang
- Zhejiang Nursing Association, Hangzhou, 310000, People’s Republic of China
| | - Jing Shao
- Department of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, People’s Republic of China
- Institute of Nursing Research, School of Medicine Zhejiang University, Hangzhou, 310058, People’s Republic of China
| | - Huafen Wang
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China
| | - Huafang Zhang
- Department of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, People’s Republic of China
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Lorenz M, Goetze D, Sargolzaei K, Frank U. The test of masticating and swallowing solids (ToMaSS): An investigation of applicability and clinical utility in children with orofacial myofunctional disorders. J Oral Rehabil 2024. [PMID: 38873707 DOI: 10.1111/joor.13776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/08/2023] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Orofacial myofunctional disorders (OMD) are often associated with limitations of oral ingestion of solid food. The Test of Masticating and Swallowing Solids (ToMaSS) is a simple diagnostic tool to assess and quantify oropharyngeal efficiency while eating a standardised cracker. OBJECTIVES The objective of this study was to investigate the applicability and clinical utility of the ToMaSS in children with OMD. METHODS In this case-control study, data were collected from 18 children between 4 and 11 years with confirmed OMD. Inter-rater reliability and age effects on the ToMaSS parameters were investigated and the specific performance profile of the OMD children was identified. RESULTS Inter-rater reliability was excellent for the ToMaSS parameters 'bites' (ICC = .999), 'masticatory cycles' (ICC = .961), 'time'(ICC≧ .999) and good for 'number of swallows' (ICC = .810). 'Masticatory cycles' and 'time' decreased as a function of age with a significant difference in the 'number of masticatory cycles' between the youngest (4-6 years) and oldest (10-14 years) participants (p = .006, Z = -2.739). Deviations from normative data in at least one of the four ToMaSS parameters were found in 90% of the OMD children with 'bites', and 'masticatory cycles' predominantly corresponding to the performances expected in typically-developing children in younger age groups. CONCLUSIONS The ToMaSS is a reliable diagnostic instrument and clinically useful to detect limited efficiency of oral solid bolus intake and specific impairments in chewing function and duration of food intake in children with OMD. Our data suggest that OMD is associated with delayed development of efficient solid bolus preparation.
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Affiliation(s)
- Marlene Lorenz
- Praxis für Logopaedie und Dysphagietherapie, Berlin, Germany
- Linguistic Department, Swallowing Research Lab, University of Potsdam, Potsdam, Germany
| | - Danae Goetze
- Linguistic Department, Swallowing Research Lab, University of Potsdam, Potsdam, Germany
- Ludwig-Maximilians-University, Munich, Germany
| | | | - Ulrike Frank
- Linguistic Department, Swallowing Research Lab, University of Potsdam, Potsdam, Germany
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Ismael-Mohammed K, Bolívar-Prados M, Laguna L, Nuñez Lara A, Clavé P. Exploring Texture and Biomechanics of Food Oral Processing in Fork-Mashable Dishes for Patients with Mastication or Swallowing Impairments. Foods 2024; 13:1807. [PMID: 38928749 PMCID: PMC11202756 DOI: 10.3390/foods13121807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Texture-modified diets (TMDs) are a primary compensatory treatment for hospitalized older patients with swallowing and mastication disorders. Nevertheless, the lack of a protocol for evaluating their objective textural properties hampers their industrialization and optimal patient care. OBJECTIVES This study aimed (a) to evaluate the textural properties (maximum force, cohesiveness, and adhesiveness) and biomechanics of food oral processing (mastication cycles, time, and frequency) of ten fork-mashable dishes (Texture E BDA/IDDSI level 6), (b) to explore the impact of oral processing on texture, and (c) to measure the properties of the ready-to-swallow bolus (RSB) in healthy adults. METHODS The textural properties (maximum force, cohesiveness, and adhesiveness) of ten dishes were analyzed with a texture analyzer before and after oral processing (RSB) in five healthy adults (30 ± 3.9, 3 women). Surface electromyography was used to measure mastication cycles, time, and frequency. RESULTS The pre-mastication Texture Profile Analysis (TPA)-averaged values of maximum force ranged from 0.65 to 2.73 N, cohesiveness was 0.49-0.87, and adhesiveness was 0.01-0.95 N·s. Masticatory Cycles (46.87-19.13 MC) and time (36.73-15.80 S) from whole samples to RSB greatly and significantly differed among dishes, although frequency did not (1.68-1.11 MC/T). Post-mastication RSB TPA-averaged values of maximum force ranged from 0.70 to 2.24 N; cohesiveness, 0.49-0.73; and adhesiveness, 0.01-1.14 N·s. CONCLUSIONS Despite all dishes being classified by the same qualitative descriptor (BDA level E/IDDSI level 6), there was a large and significant variation in their textural properties (maximum force, cohesiveness, and adhesiveness) when measured in SI units. In addition, in healthy adults, the masticatory cycles and time to achieve RSB greatly differed, whereas masticatory frequency remained quite constant.
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Affiliation(s)
- Kovan Ismael-Mohammed
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, 08304 Mataró, Spain
- Institute of Agrochemistry and Food Technology (IATA, CISC), 46980 Valencia, Spain
| | - Mireia Bolívar-Prados
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, 08304 Mataró, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), 08304 Barcelona, Spain
| | - Laura Laguna
- Institute of Agrochemistry and Food Technology (IATA, CISC), 46980 Valencia, Spain
| | - Adrian Nuñez Lara
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, 08304 Mataró, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), 08304 Barcelona, Spain
| | - Pere Clavé
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, 08304 Mataró, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), 08304 Barcelona, Spain
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Saito N, Ogawa T, Shiraishi N, Koide R, Komine H, Yokoyama M, Hanawa S, Sasaki K. Difference in the Electromyographic Behavior of the Masticatory and Swallowing Muscles During Cued Versus Spontaneous Swallowing. Dysphagia 2024; 39:398-406. [PMID: 37752277 PMCID: PMC11127863 DOI: 10.1007/s00455-023-10621-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/10/2023] [Indexed: 09/28/2023]
Abstract
The risk of dysphagia and/or aspiration is determined using screening tests, such as the repeated saliva swallowing test and modified water swallowing test, which evaluate cued swallowing. However, humans masticate and swallow foods with various consistencies, forms, and amounts, without conscious awareness. Therefore, this study aimed to examine the difference in the behavior of masticatory and swallowing muscles during spontaneous versus cued swallowing through a series of mastication and swallowing processes by evaluating surface electromyogram (sEMG) signals. The effect of the consistency and amount of food on the behavior of these muscles was also investigated. The sEMG recordings of the masseter muscles and anterior belly of the digastric muscle for 12 subjects, and genioglossus muscle for 5 subjects were obtained. The genioglossus activity was recorded using custom-made ball electrodes. The test foods were cookies and tofu, in amounts of 2 g and 4 g. The normalized muscle activity (integrated EMG), duration of the muscle activity, initial activation timepoint of each muscle, and total duration of swallowing were compared among four conditions. The activity of each muscle was significantly higher during the swallowing of cookies than tofu, for 4 g vs 2 g, and for cued versus spontaneous swallowing. The duration of each muscle activity, initial activation timepoint, and total duration of swallowing were significantly longer for cookies versus tofu, for 4 g vs 2 g, and for spontaneous versus cued swallowing. These results suggest that the behavior of the masticatory and swallowing muscles is affected by cued swallowing and by the consistency and amount of food.
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Affiliation(s)
- Naoya Saito
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Toru Ogawa
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Naru Shiraishi
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Rie Koide
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Hideya Komine
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Masayoshi Yokoyama
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Soshi Hanawa
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
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Aseef A, Dodderi T, Muthukumar V, Krishnamurthy R, Balasubramanium RK, Kothari M. Test of mastication and swallowing solids in healthy individuals aged 6 to 20 years: A normative study in an Indian context. J Oral Rehabil 2024. [PMID: 38767112 DOI: 10.1111/joor.13741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND The Test of Mastication and Swallowing Solids (TOMASS) is a reliable tool for assessing chewing and swallowing in healthy adults, using commercially available crackers. TOMASS-Children (TOMASS-C) is the paediatric version of TOMASS. OBJECTIVE The present study aimed to establish normative data for TOMASS-C using a validated regional commercial cracker among healthy individuals aged between 6-20 years of India. METHODS 327 healthy individuals between 6-20 years were recruited in a cross-sectional study design following a convenient sampling procedure. Participants consumed one validated regional cracker and the procedure was video recorded. Data were stratified according to age groups (6-7, 8-9, 10-13, 14-17 and 18-20 years) and sex (boys and girls). Two Speech Language Pathologists independently analysed the video recordings to derive discrete bites, masticatory cycles, swallows and total swallow time indices. Using them, time/swallow, masticatory cycles/bite, swallows/bite and time/bite were calculated. RESULTS All parameters of TOMASS-C had moderate to good (0.6-0.85) test-retest reliability and moderate to excellent (0.69-0.99) inter-rater reliability at p > .000. Younger participants took more bites, chewed more times and swallowed more frequently with longer chewing and swallowing time. Boys exhibited a lower number of swallows, shorter swallow time and reduced total masticatory time at p > .05. Additionally, girls demonstrated fewer bites and chewing cycles compared to boys at p > .05. CONCLUSION TOMASS-C using a validated regional cracker was feasible and reliable. Normative data established for healthy boys and girls between 6-20 years offers much-needed quantitative data to objectively delineate individuals with and without chewing and swallowing solid food difficulties.
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Affiliation(s)
- Ambreen Aseef
- Department of Audiology and Speech Language Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, India
| | - Thejaswi Dodderi
- Department of Audiology and Speech Language Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, India
| | - Varsha Muthukumar
- Department of Audiology and Speech Language Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, India
| | - Rahul Krishnamurthy
- Special Education and Communication Disorders (SECD), University of Nebraska-Lincoln, Lincoln, USA
| | - Radish Kumar Balasubramanium
- Department of Audiology and Speech Language Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, India
| | - Mohit Kothari
- Department of Audiology and Speech Language Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, India
- Hammel Neurorehabilitation Center and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark
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Bhattarai B, Vijayan SK, Swapna N. Comparison of Oropharyngeal Efficiency Between Two Popular Brands of Marie Biscuits. Indian J Otolaryngol Head Neck Surg 2023; 75:1687-1693. [PMID: 37636620 PMCID: PMC10447802 DOI: 10.1007/s12070-023-03709-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/15/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE The main objective of the study was to compare four measures of TOMASS (number of bites, number of masticatory cycles, number of swallowing and total time taken) across brands of Marie biscuits and gender. METHODOLOGY The study employed a cross-sectional design with nonrandomized convenience sampling. A total of 60 participants (30 females and 30 males) were recruited for the study in the age range of 18 to 26 years. Prior to enrolment in the study, the participants were screened for potential speech and swallowing issues. Two commercially available crackers (biscuits) in India, Sunfeast Marie Light and Britannia Marie Gold were used. Video recordings of the participants eating the biscuits were analyzed to document four measures of TOMASS. RESULTS The mean values obtained on all the measures for males were lesser than mean values for females for both the biscuits. Mann-Whitney U test revealed a statistically significant difference across number of swallows and total time taken across gender. There were no significant differences across biscuits on the four TOMASS measures. CONCLUSION It can be concluded that the TOMASS measures were near similar for both brands of Marie biscuits. Thus, any of these two brands of Marie could be used for clinical swallow evaluation. However, gender needs to be kept in mind, while interpreting the results of TOMASS. Future studies need to be conducted with other brands of Marie biscuit and in other age groups.
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Affiliation(s)
- Biraj Bhattarai
- MSc. SLP, All India Institute of Speech and Hearing, Mysuru, India
| | - Syam Krishna Vijayan
- Junior Research Fellow, All India Institute of Speech and Hearing, Mysuru, India
| | - N Swapna
- Professor of Speech Pathology, All India Institute of Speech and Hearing, Mysuru, India
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Nakayama E, Tohara H, Sakai M, Iida M, Abe K, Ueda K. Kinematic Features of Mandibular Movement during Mastication in Geriatric Individuals Who Are Provided with a Dysphagia Diet at Long-Term Care Facilities. Nutrients 2023; 15:nu15102273. [PMID: 37242156 DOI: 10.3390/nu15102273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/02/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Providing a normal diet to a care recipient who is unable to form an adequate bolus may cause suffocation or aspiration pneumonia. We investigated whether differences in kinematic data of mandibular movements during mastication can be used as an indicator of the need for a dysphagia diet in the elderly in long-term care facilities. We included 63 participants who were provided with solid food in two long-term care facilities. The primary outcome variable was the kinematic data on mandibular movement during cracker chewing. The analysis results were compared between the normal and dysphagia diet groups. Logistic regression analysis and receiver operating characteristic curve analyses were performed. Significant differences were observed in the masticatory time, cycle frequency, total change amount, number of linear motions, and circular motion frequency between the normal and modified diet groups. The odds ratio for the circular motion frequency was -0.307, and the calculated cutoff value was 63%, with a sensitivity of 71.4%, a specificity of 73.5%, and an area under the curve of 0.714. Thus, these characteristics may be useful for detecting care recipients who need to be provided with a dysphagia diet. Moreover, the circular motion frequency could be used as a screening test to identify people who need a dysphagia diet.
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Affiliation(s)
- Enri Nakayama
- The Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo 101-8310, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Mayu Sakai
- The Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo 101-8310, Japan
| | - Masato Iida
- The Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo 101-8310, Japan
| | - Kimiko Abe
- The Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo 101-8310, Japan
| | - Koichiro Ueda
- The Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo 101-8310, Japan
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Cordier R, Speyer R, Martinez M, Parsons L. Reliability and Validity of Non-Instrumental Clinical Assessments for Adults with Oropharyngeal Dysphagia: A Systematic Review. J Clin Med 2023; 12:jcm12020721. [PMID: 36675650 PMCID: PMC9861493 DOI: 10.3390/jcm12020721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/12/2022] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
This systematic review on non-instrumental clinical assessment in adult oropharyngeal dysphagia (OD) provides an overview of published measures with reported reliability and validity. In alignment with PRISMA, four databases (CINAHL, Embase, PsycINFO, and PubMed) were searched, resulting in a total of 16 measures and 32 psychometric studies included. The included measures assessed any aspect of swallowing, consisted of at least one specific subscale relating to swallowing, were developed by clinical observation, targeted adults, and were developed in English. The included psychometric studies focused on adults, reported on measures for OD-related conditions, described non-instrumental clinical assessments, reported on validity or reliability, and were published in English. Methodological quality was assessed using the standard quality assessment QualSyst. Most measures targeted only restricted subdomains within the conceptual framework of non-instrumental clinical assessments. Across the 16 measures, hypothesis testing and reliability were the most reported psychometrics, whilst structural validity and content validity were the least reported. Overall, data on the reliability and validity of the included measures proved incomplete and frequently did not meet current psychometric standards. Future research should focus on the development of comprehensive non-instrumental clinical assessments for adults with OD using contemporary psychometric research methods.
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Affiliation(s)
- Reinie Cordier
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne NE7 7XA, UK
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
- Department of Health & Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa
| | - Renée Speyer
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
- Department Special Needs Education, Faculty of Educational Sciences, University of Oslo, 0318 Oslo, Norway
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, 1233 XA Leiden, The Netherlands
- Correspondence:
| | - Matthew Martinez
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne NE7 7XA, UK
| | - Lauren Parsons
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
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