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Lai CJ, Jhuang JR, Tu YK, Liu CM, Tsai CY, Chien KL. Relationship Between Subjective Questionnaires and Videofluoroscopy of Dysphagia Evaluation: A Systematic Review and Meta-Analysis. J Nurs Res 2024; 32:e324. [PMID: 38506593 DOI: 10.1097/jnr.0000000000000608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Early detection of dysphagia is important for preventing aspiration pneumonia. Although videofluoroscopy is currently the primary diagnostic tool for dysphagia, access to this tool may be limited because of radiation exposure risk, high cost, and other factors. PURPOSE In this study, a meta-analysis was used to determine the strength of the correlation between dysphagia detection outcomes obtained using subjective questionnaires and videofluoroscopy. METHODS The PubMed and Embase databases were searched for original articles up to December 2022. Studies published in English that used cross-sectional designs to assess the correlation between subjective questionnaires and videofluoroscopy were considered eligible for inclusion. The search terms used included "dysphagia," "questionnaire," and "videofluoroscopy." Two reviewers critically appraised and extracted the correlation coefficient r values. In addition, a random-effects meta-analysis was conducted. The Q statistic was used to assess the heterogeneity among the included studies. Publication bias was checked using the funnel plot and Egger's tests. Multilevel analysis was used to determine sensitivity to consider within-study correlations. In addition, subgroup analyses were conducted based on type of questionnaire, head and neck cancer, and English-speaking regions. RESULTS The meta-analysis included five studies and 856 patients using the Eating Assessment Tool-10 and one study and 27 patients using the Sydney Swallow Questionnaire. The results of the random-effects meta-analysis showed a moderate relationship between the subjective questionnaires and videofluoroscopy ( r = .35, 95% CI [0.20, 0.48]). Similar results were also obtained using multilevel analysis ( r = .34, 95% CI [0.25, 0.42]). No publication bias was found for any of the studies ( p = .88). In the subgroup analyses, a moderate relationship between Eating Assessment Tool-10 and videofluoroscopy ( r = .31, 95% CI [0.19, 0.42]) and an ultrahigh relationship between Sydney Swallow Questionnaire and video-fluoroscopy ( r = .74, 95% CI [0.50, 0.87]) were found. Furthermore, moderate associations were observed within each head and neck cancer and English-speaking regions subgroup. However, no significant differences were found between these two subgroups. CONCLUSIONS These results indicate the subjective questionnaires considered in this study share a moderate relationship with videofluoroscopy. Subjective questionnaires may be used as an auxiliary tool by nurses and homecare givers for the early assessment of dysphagia risk in patients.
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Affiliation(s)
| | | | - Yu-Kang Tu
- PhD, Professor, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Min Liu
- MD, Attending Anesthesiologist, Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Ying Tsai
- BSN, RN, Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuo-Liong Chien
- MD, PhD, Professor, Institute of Epidemiology and Preventive Medicine, and Population Health Research Center, National Taiwan University, Taipei, Taiwan
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Chen Y, Li C, Fan Y, Jiao L, Silverman M, Ishimaru M, Wang J, Van Pelt AJ, Wang R. Associations of oral health status and swallowing function with cognitive impairment in the aging population: a cross-sectional study. BMC Oral Health 2023; 23:912. [PMID: 37993856 PMCID: PMC10666324 DOI: 10.1186/s12903-023-03640-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/08/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND The purpose of this study was to investigate the relationships of oral health status and swallowing function with cognitive impairment in community-dwelling older adults from Changsha, Hunan Province, China. METHODS In this cross-sectional study, we analyzed the data of 215 participants aged ≥ 50 years which were retrieved from the Xiangya and Panasonic mild cognitive impairment (MCI) Study, a community-based study conducted among the residents of the urban areas of Hunan province in China. Demographic information of all participants was collected. We determined oral function by evaluating oral hygiene, oral dryness, occlusal force, tongue pressure, chewing function, swallowing function, remaining teeth number, and other indicators. The mini-mental state examination (MMSE) was used to screen for cognitive function. The relationship between each oral function evaluation item and cognitive function was investigated using correlation analysis. The associations between oral health status and swallowing function with cognitive impairment were inferred using multiple regression analysis. RESULTS The general characteristics of participants showed statistically significant correlation coefficients in number of teeth remaining (p = 0.003) and number of teeth lost (p < 0.0001). Almost half of the 25 participants (48%) were aged from 70-80 years. Only 25 older adults (11.6% of the participants) were determined to have cognitive impairment by MMSE sores less than 24. Tongue pressure in male participants was the only significant independent variable that was associated with cognitive impairment (p = 0.01971). The results indicate that male participants with lower MMSE scores had a relative deficiency in tongue pressure. CONCLUSIONS In this cross-sectional study, the oral health status and swallowing function of participants were in relatively good condition and showed low correlations with cognitive impairment. However, lower tongue pressures were associated with lower MMSE scores in males, indicating it could serve as a novel oral function index for evaluating cognitive impairment.
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Affiliation(s)
- Yong Chen
- Laboratory of Food Oral Processing, School of Food Science & Biotechnology, Zhejiang Gongshang University, Hangzhou, Zhejiang, China
| | - Canyang Li
- Rehabilitation Medicine Department, Speech and Language Pathology Therapy Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yongmei Fan
- Rehabilitation Medicine Department, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lili Jiao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, of Central South University, Changsha, Hunan, China
| | - Matthew Silverman
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | | | - Jing Wang
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Alice J Van Pelt
- Section of Gastroenterology, Jr. VA Hospital, Edward Hines, Hines, IL, USA
- Division of Gastroenterology and Nutrition, Loyola University Stritch School of Medicine, Maywood, IL, USA
| | - Rumi Wang
- Rehabilitation Medicine Department, Speech and Language Pathology Therapy Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
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Hu X, Liv P, Lundström E, Norström F, Lindahl O, Borg K, Sunnerhagen KS. Study protocol for a randomized, controlled, multicentre, pragmatic trial with Rehabkompassen®-a digital structured follow-up tool for facilitating patient-tailored rehabilitation in persons after stroke. Trials 2023; 24:650. [PMID: 37803460 PMCID: PMC10559468 DOI: 10.1186/s13063-023-07673-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/25/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Stroke is a leading cause of disability among adults worldwide. A timely structured follow-up tool to identify patients' rehabilitation needs and develop patient-tailored rehabilitation regimens to decrease disability is largely lacking in current stroke care. The overall purpose of this study is to evaluate the effectiveness of a novel digital follow-up tool, Rehabkompassen®, among persons discharged from acute care settings after a stroke. METHODS This multicentre, parallel, open-label, two-arm pragmatic randomized controlled trial with an allocation ratio of 1:1 will be conducted in Sweden. A total of 1106 adult stroke patients will have follow-up visits in usual care settings at 3 and 12 months after stroke onset. At the 3-month follow-up, participants will have a usual outpatient visit without (control group, n = 553) or with (intervention group, n = 553) the Rehabkompassen® tool. All participants will receive the intervention at the 12-month follow-up visit. Feedback from the end-users (patient and health care practitioners) will be collected after the visits. The primary outcomes will be the patients' independence and social participation at the 12-month visits. Secondary outcomes will include end-users' satisfaction, barriers and facilitators for adopting the instrument, other stroke impacts, health-related quality of life and the cost-effectiveness of the instrument, calculated by incremental cost per quality-adjusted life year (QALY). DISCUSSION The outcomes of this trial will inform clinical practice and health care policy on the role of the Rehabkompassen® digital follow-up tool in the post-acute continuum of care after stroke. TRIAL REGISTRATION ClinicalTrials.gov NCT04915027. Registered on 4 June 2021. ISRCTN registry ISRCTN63166587. Registered on 21 August 2023.
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Affiliation(s)
- Xiaolei Hu
- Department of Community Medicine and Rehabilitation, Umeå University, Neuro-Head-Hals-Centrum, University Hospital of Umeå, Umeå, 901 87, Sweden.
| | - Per Liv
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Erik Lundström
- Department of Medical Sciences, Neurology, Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden
| | - Fredrik Norström
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Olof Lindahl
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden
| | - Kristian Borg
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden
| | - Katharina S Sunnerhagen
- Department of Neuroscience and Physiology, Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden
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Selvaraj JL, Venkatesh L, Varadharajan V, Chandrasekar K, Srinivas S, John C. Development and Evaluation of the Psychometric Properties of the Tamil Version of Eating Assessment Tool - 10 (EAT-10): Preliminary Findings from Persons with Head and Neck Cancer. Indian J Otolaryngol Head Neck Surg 2023; 75:632-640. [PMID: 37275015 PMCID: PMC10234939 DOI: 10.1007/s12070-022-03376-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Aims: This study aimed to develop and evaluate the psychometric properties of the Tamil version of the Eating Assessment Tool (EAT-10). Setting & Study Design: Prospective cross-sectional study on persons with Head and Neck Cancer (HNC) during their follow-up for oncological and swallowing consultation at a tertiary care hospital and healthy individuals recruited from the community. Methods: The study was conducted in two phases: (1) translation and development of the Tamil version of EAT-10 and (2) administration of Tamil EAT-10 to assess internal consistency reliability, test-retest reliability and known-group validity. 92 participants with HNC in the clinical group and 149 healthy adults in the control group completed the Tamil EAT-10. In addition, a subgroup of 20 participants with HNC repeated the questionnaire within a week to assess test-retest reliability. Results: The Cronbach alpha for the 10 items was 0.96 indicating high internal consistency reliability. The test-retest reliability of the individual items and the total scores (r = 0.98) of the Tamil version of EAT-10 were high. The total EAT-10 scores for the HNC group (14.4 ± 11.5) were significantly higher (p < 0.001) than the scores for healthy adults (0.72 ± 2.0). Conclusion: The Tamil version of the EAT-10 developed in this study is a reliable and valid self-administered tool for identifying concerns related to swallowing among persons treated for HNC and healthy adults. This tool can be implemented for clinical practice and research in dysphagia among a Tamil-speaking population. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03376-8.
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Affiliation(s)
- Jasmine Lydia Selvaraj
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Lakshmi Venkatesh
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Vasudharany Varadharajan
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Kavyashree Chandrasekar
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Satish Srinivas
- Department of Radiation Oncology, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra Institute of Higher Education & Research, Porur, Chennai, India
| | - Christopher John
- Department of Radiation Oncology, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra Institute of Higher Education & Research, Porur, Chennai, India
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Verma H, Kaur H, Benison P, Harisha M, Balaji J. Trans-Adaptation and Analysis of Psychometric Properties of Hindi Version of Eating Assessment Tool-10 (EAT-10H). Dysphagia 2023; 38:622-628. [PMID: 35819529 DOI: 10.1007/s00455-022-10491-9] [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: 10/20/2021] [Accepted: 06/23/2022] [Indexed: 11/03/2022]
Abstract
The present study aims to trans-adapt the Eating Assessment Tool-10 (EAT-10) to the Hindi language and assess its psychometric properties. The original EAT-10 was translated into Hindi language using the forward-backward translation method. A total of 201 participants were included in the study. Among 201 participants, 83 were controls, and 118 were dysphagic. Internal consistency, reliability, and clinical validity were measured. Results revealed that the Hindi version of EAT-10 exhibited an excellent internal consistency (i.e., 0.86). A significant difference was found between the mean scores of both groups, and an excellent reliability score (i.e., 0.96) was obtained. From the present study's findings, it can be delineated that the Hindi version of EAT-10 exhibited good psychometric properties. So, the developed tool is a quick, reliable, and valid tool.
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Affiliation(s)
- Himanshu Verma
- Speech & Hearing Unit, Department of Otolaryngology, PGIMER, Chandigarh, 160012, India.
| | - Harleen Kaur
- Department of Otolaryngology, Sir Ganga Ram Hospital, New Delhi, India
| | - Philemon Benison
- Department of Speech-Language Pathology, Ucchvas Rehabilitation Center, Hyderabad, India
| | - Madishetty Harisha
- Department of Speech-Language Pathology, One Special Place, Hyderabad, India
| | - Janaki Balaji
- Department of Speech-Language Pathology, Communicate with Us Rehabilitation Center, Chennai, Tamil Nadu, India
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