TY - JOUR
T1 - Development and validation of a new screening questionnaire for dysphagia in early stages of Parkinson's disease
AU - Simons, Janine A.
AU - Fietzek, Urban M.
AU - Waldmann, Annika
AU - Warnecke, Tobias
AU - Schuster, Tibor
AU - Ceballos-Baumann, Andrés O.
N1 - Funding Information:
Dr. Schuster's current affiliation is supported by the Canadian Network for Observational Drug Effect Studies (CNODES). CNODES is funded by a grant from Health Canada, the Drug Safety and Effectiveness Network (DSEN), and the Canadian Institutes for Health Research (CIHR).
Funding Information:
Prof. Dr. Ceballos-Baumann has received an unrestricted grant from the German Parkinson Association (Deutsche Parkinson Vereinigung e.V.) and the German Foundation for Neurology (Deutsche Stiftung Neurologie). He has received honoraria for advisory work or speeches from Archimedes, Allergan, Desitin, GlaxoSmithKline, Ipsen, Licher-MT, Meda, Merz, Medtronic, Novartis, Orion, Teva, UCB.
PY - 2014/9
Y1 - 2014/9
N2 - Background: Dysphagia in patients with Parkinson's disease (PD) significantly reduces quality of life and predicted lifetime. Current screening procedures are insufficiently evaluated. We aimed to develop and validate a patient-reported outcome questionnaire for early diagnosis of dysphagia in patients with PD. Methods: The two-phased project comprised the questionnaire, diagnostic scales construction (N=105), and a validation study (N=82). Data for the project were gathered from PD patients at a German Movement Disorder Center. For validation purposes, a clinical evaluation focusing on swallowing tests, tests of sensory reflexes, and fiberoptic endoscopic evaluation of swallowing (FEES) was performed that yielded a criteria sum score against which the results of the questionnaire were compared. Specificity and sensitivity were evaluated for the detection of noticeable dysphagia and for the risk of aspiration. Results: The Munich Dysphagia Test - Parkinson's disease (MDT-PD) consists of 26 items that show high internal consistency (α=0.91). For the validation study, 82 patients, aged 70.9±8.7 (mean±SD), with a median Hoehn & Yahr stage of 3, were assessed. 73% of patients had dysphagia with noticeable oropharyngeal symptoms (44%) or with penetration/aspiration (29%). The criteria sum score correlated positively with the screening result (r=0.70, p<0.001). The MDT-PD sum score classified not noticeable dysphagia vs. risk of aspiration (noticeable dysphagia) with a sensitivity of 90% (82%) and a specificity of 86% (71%), and yielded similar results in cross-validation, respectively. Conclusions: MDT-PD is a valid screening tool for early diagnosis of swallowing problems and aspiration risk, as well as initial graduation of dysphagia severity in PD patients.
AB - Background: Dysphagia in patients with Parkinson's disease (PD) significantly reduces quality of life and predicted lifetime. Current screening procedures are insufficiently evaluated. We aimed to develop and validate a patient-reported outcome questionnaire for early diagnosis of dysphagia in patients with PD. Methods: The two-phased project comprised the questionnaire, diagnostic scales construction (N=105), and a validation study (N=82). Data for the project were gathered from PD patients at a German Movement Disorder Center. For validation purposes, a clinical evaluation focusing on swallowing tests, tests of sensory reflexes, and fiberoptic endoscopic evaluation of swallowing (FEES) was performed that yielded a criteria sum score against which the results of the questionnaire were compared. Specificity and sensitivity were evaluated for the detection of noticeable dysphagia and for the risk of aspiration. Results: The Munich Dysphagia Test - Parkinson's disease (MDT-PD) consists of 26 items that show high internal consistency (α=0.91). For the validation study, 82 patients, aged 70.9±8.7 (mean±SD), with a median Hoehn & Yahr stage of 3, were assessed. 73% of patients had dysphagia with noticeable oropharyngeal symptoms (44%) or with penetration/aspiration (29%). The criteria sum score correlated positively with the screening result (r=0.70, p<0.001). The MDT-PD sum score classified not noticeable dysphagia vs. risk of aspiration (noticeable dysphagia) with a sensitivity of 90% (82%) and a specificity of 86% (71%), and yielded similar results in cross-validation, respectively. Conclusions: MDT-PD is a valid screening tool for early diagnosis of swallowing problems and aspiration risk, as well as initial graduation of dysphagia severity in PD patients.
UR - http://www.scopus.com/inward/record.url?scp=84906315092&partnerID=8YFLogxK
U2 - 10.1016/j.parkreldis.2014.06.008
DO - 10.1016/j.parkreldis.2014.06.008
M3 - Journal articles
C2 - 25012695
AN - SCOPUS:84906315092
SN - 1353-8020
VL - 20
SP - 992
EP - 998
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
IS - 9
ER -