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Consistencies among miscellaneous scales for evaluation of post-stroke dysphagia

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Post-stroke dysphagia (PSD) is the most common type of dysphagia. Stroke patients with sustained dysphagia have poorer outcomes. The severity of PSD is assessed using miscellaneous scales with unknown consistencies. We aim to investigate the consistencies among miscellaneous scales, which could aid in the assessment of PSD.

Methods

A total of 49 PSD patients were enrolled. Functional Oral Intake Scale (FOIS), Dysphagia Severity Scale (DSS), Ohkuma Questionnaire, Eating Assessment Tool-10, and Repetitive Saliva Swallowing Test were performed. FOIS was performed by physicians, and DSS was conducted by both the physicians and nurses; the physicians used either videofluoroscopy (VF) or videoendoscopy (VE) for evaluation; while, the nurses assessed PSD by observation and subjective judgment.

Results

When using VF (VF-DSS and VF-FOIS) as the gold standard for the evaluation, VE-FOIS (κ = 0.625, 95% CI 0.300–0.950, p < 0.001) has a substantial agreement with VF-FOIS, and VE-DSS (κ = 0.381, 95% CI 0.127–0.636, p = 0.007) has a fair agreement with VF-DSS. The weighted kappa of FOIS to DSS in VE (weighted κ = 0.577, 95% CI 0.414–0.740, p < 0.001) is not lower than that in VF (weighted kappa = 0.249, 95% CI 0.136–0.362, p < 0.001).

Conclusion

For both DSS and FOIS, only VE has a statistically significant agreement with VF. Though VF has been viewed as the traditional gold standard of dysphagia screening, it has the limitations of being invasive and equipment dependent. For PSD, VE could be considered as a substitution when VF is not available or suitable.

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Availability of data and materials

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Data are located in controlled access data storage at Kaohsiung Municipal Siaogang Hospital.

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Acknowledgements

This work was supported partially by the grants from the Kaohsiung Municipal Siaogang Hospital (KMSH S-108-08) and from the Ministry of Science and Technology (MOST 108-2218-E010-005, MOST 109-2224-E010-001, MOST-110-2221-E-008-048).

Funding

This research did not receive any funding from agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Wen-Ching Chen and Chung-Wei Lin are first authors with equal contributions.

Authors and Affiliations

  1. Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100 , Tzyou 1st Road, Kaohsiung City, 807, Taiwan

    Wen-Ching Chen, Meng-Ni Wu, Yi-On Fong, Chun-Hung Chen, Sun-Wung Hsieh & Poyin Huang

  2. Department of Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Chung-Wei Lin

  3. School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chung-Wei Lin

  4. Department of Neurology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chun-Hung Chen, Sun-Wung Hsieh & Poyin Huang

  5. Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chun-Hung Chen, Sun-Wung Hsieh & Poyin Huang

  6. Dysphagia Functional Reconstructive Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chun-Hung Chen, Sun-Wung Hsieh & Poyin Huang

  7. Multidisciplinary Swallowing Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chun-Hung Chen & Poyin Huang

  8. Department of Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Sun-Wung Hsieh & Poyin Huang

  9. Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chih-Yin Elizabeth Chen

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  1. Wen-Ching Chen
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Chen, WC., Lin, CW., Wu, MN. et al. Consistencies among miscellaneous scales for evaluation of post-stroke dysphagia. Eur Arch Otorhinolaryngol 280, 4561–4567 (2023). https://doi.org/10.1007/s00405-023-08101-x

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