[How reliable are non-instrumental assessment tools for dysphagia?].

S Miller, D Kühn, M Jungheim, M Ptok
Author Information
  1. S Miller: Klinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, MHH OE 6510, 30623, Hannover, Deutschland, Miller.Simone@mh-hannover.de.

Abstract

BACKGROUND: The requirement for otorhinolaryngologists and phoniatricians to diagnose dysphagia and evaluate its extent is on the rise, particularly in light of demographic changes. The gold standards in confirmatory diagnostics are fiberoptic endoscopic evaluation of swallowing (FEES) and the videofluoroscopic swallowing examination (VFS). Standardized assessments, such as questionnaires or assessments involving probatory swallows are often applied as screening or supportive measures. This article aims to give a critical overview of the assessment tools frequently used in clinical routine. Test quality is assessed, particularly compared to FEES and VFS.
METHODS: A selective literature search using PubMed has been conducted.
RESULTS: On the basis of this lierature search, 48 assessment tools were identified. These can be classified into screening tools, instrument-based tools (implementation standards and evaluation protocols) and questionnaire-based assessment inventories.
DISCUSSION: In order to diagnose and evaluate dysphagia on the basis of assessment critieria, clinicians should be aware of indications for, as well as the advantages, disadvantages and test quality of the assessment tools. Considering the different assessment tools for anamnesis and probatory swallowing, rather low sensitivities and specificities for possible penetration and aspiration are evident. In cases where these symptoms of dysphagia are not evident and reliably assessable, confirmatory assessment via FEES or VFS is essential.

References

  1. Rev Laryngol Otol Rhinol (Bord). 2012;133(1):19-26 [PMID: 23074821]
  2. Dysphagia. 1996 Summer;11(3):217-8 [PMID: 8755469]
  3. Dysphagia. 2013 Mar;28(1):24-32 [PMID: 22684923]
  4. Laryngorhinootologie. 2013 Feb;92(2):80-9 [PMID: 23175236]
  5. Arch Otolaryngol Head Neck Surg. 2001 Jul;127(7):870-6 [PMID: 11448365]
  6. Q J Med. 1993 Dec;86(12):825-9 [PMID: 8108539]
  7. Int Nurs Rev. 2006 Jun;53(2):143-9 [PMID: 16650034]
  8. Neurogastroenterol Motil. 2013 Apr;25(4):278-82 [PMID: 23480388]
  9. Rev Laryngol Otol Rhinol (Bord). 2010;131(1):19-22 [PMID: 21077412]
  10. Cancer. 1996 Jun 1;77(11):2294-301 [PMID: 8635098]
  11. J Neurol Neurosurg Psychiatry. 1992 Sep;55(9):822-5 [PMID: 1402974]
  12. Dysphagia. 2012 Dec;27(4):491-7 [PMID: 22350113]
  13. Dysphagia. 1994 Spring;9(2):120-9 [PMID: 8005007]
  14. Dysphagia. 2003 Summer;18(3):203-10 [PMID: 14506986]
  15. J Pain Symptom Manage. 2013 Aug;46(2):201-6 [PMID: 23159683]
  16. Arch Phys Med Rehabil. 2005 Aug;86(8):1516-20 [PMID: 16084801]
  17. Dysphagia. 2000 Summer;15(3):122-33 [PMID: 10839824]
  18. Gastroenterology. 2000 Apr;118(4):678-87 [PMID: 10734019]
  19. Dysphagia. 1996 Spring;11(2):99-103 [PMID: 8721067]
  20. Arch Neurol. 1992 Dec;49(12):1259-61 [PMID: 1449405]
  21. Dysphagia. 1988;2(4):216-9 [PMID: 3251697]
  22. Stroke. 2006 Dec;37(12):2984-8 [PMID: 17095740]
  23. Cancer. 1990 Aug 1;66(3):564-9 [PMID: 2364368]
  24. Age Ageing. 2000 Nov;29(6):495-9 [PMID: 11191240]
  25. Arch Phys Med Rehabil. 1994 Dec;75(12):1284-6 [PMID: 7993165]
  26. Oral Oncol. 2010 Apr;46(4):e10-4 [PMID: 20219415]
  27. J Neurol Neurosurg Psychiatry. 1997 Oct;63(4):456-60 [PMID: 9343123]
  28. QJM. 1998 Dec;91(12):829-35 [PMID: 10024948]
  29. Dysphagia. 2001 Winter;16(1):1-6 [PMID: 11213241]
  30. Dysphagia. 2012 Mar;27(1):46-52 [PMID: 21424584]
  31. Arch Phys Med Rehabil. 1996 Dec;77(12):1226-32 [PMID: 8976303]
  32. Rev Laryngol Otol Rhinol (Bord). 2008;129(2):97-100 [PMID: 18767327]
  33. Age Ageing. 1998 Mar;27(2):99-106 [PMID: 16296668]
  34. J Neurosci Nurs. 2002 Oct;34(5):252-3, 257-60 [PMID: 12391741]
  35. Dysphagia. 2008 Dec;23(4):392-405 [PMID: 18855050]
  36. J Rehabil Med. 2005 Jul;37(4):247-51 [PMID: 16024482]
  37. Dysphagia. 2011 Dec;26(4):407-14 [PMID: 21279522]
  38. Disabil Rehabil. 2010;32(14):1163-72 [PMID: 20078206]
  39. Dysphagia. 2002 Spring;17(2):97-114 [PMID: 11956835]
  40. Nestle Nutr Inst Workshop Ser. 2012;72:19-31 [PMID: 23051997]
  41. Ann Otol Rhinol Laryngol. 2008 Dec;117(12):919-24 [PMID: 19140539]
  42. Disabil Rehabil. 2009;31(10):825-30 [PMID: 19037776]
  43. Dysphagia. 1996 Spring;11(2):93-8 [PMID: 8721066]
  44. Dysphagia. 2008 Sep;23(3):244-50 [PMID: 18058175]
  45. Dysphagia. 2000 Winter;15(1):19-30 [PMID: 10594255]
  46. Stroke. 2009 Feb;40(2):555-61 [PMID: 19074483]
  47. Dysphagia. 2002 Fall;17(4):308-15 [PMID: 12355146]
  48. Cerebrovasc Dis. 2009;28(3):283-9 [PMID: 19609080]
  49. Arch Phys Med Rehabil. 2000 Aug;81(8):1030-3 [PMID: 10943750]
  50. Head Neck. 1996 Jan-Feb;18(1):1-10 [PMID: 8774916]
  51. Stroke. 2007 Nov;38(11):2948-52 [PMID: 17885261]
  52. Odontology. 2014 Jan;102(1):76-80 [PMID: 23053789]
  53. Cerebrovasc Dis. 2008;26(1):41-7 [PMID: 18511871]
  54. Dysphagia. 1999 Summer;14(3):139-45 [PMID: 10341109]
  55. J Clin Nurs. 2001 Jul;10(4):463-73 [PMID: 11822494]
  56. Clin Nutr. 2008 Dec;27(6):806-15 [PMID: 18789561]
  57. Nervenarzt. 2002 Apr;73(4):364-70 [PMID: 12040985]
  58. HNO. 2010 Jul;58(7):692-7 [PMID: 20464359]

MeSH Term

Deglutition Disorders
Diagnostic Self Evaluation
Humans
Mass Screening
Quality of Life
Reproducibility of Results
Sensitivity and Specificity
Surveys and Questionnaires

Word Cloud

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