Dysphagia

, Volume 33, Issue 3, pp 273–281 | Cite as

Dysphagia in Multiple Sclerosis: Evaluation and Validation of the DYMUS Questionnaire

  • Dalal Alali
  • Kirrie Ballard
  • Steve Vucic
  • Hans Bogaardt
Review

Abstract

Objective

The 10-item Dysphagia in Multiple Sclerosis (DYMUS) questionnaire is a self-administered tool used to identify swallowing problems in adults with MS. The questionnaire was not validated against other existing questionnaires to assess its convergent validity. Moreover, its test–retest reliability was not measured previously. Therefore, the purpose of this study was to assess the factor analysis, internal consistency and test–retest reliability of the DYMUS, as well as its convergent validity against an established and validated questionnaire, the EAT-10.

Method

English-speaking adults with MS in New South Wales, Australia who were seen for routine medical check-ups were invited to complete two questionnaires across two phases. One hundred participants completed phase 1, while 55 completed phase 2. Statistical analyses were performed to investigate the psychometric properties of the DYMUS questionnaire.

Results

Internal consistency (Cronbach’s Alpha) reduced the DYMUS questionnaire from ten to five items. The shortened version of the DYMUS showed high internal consistency (alpha = 0.904). It also showed satisfactory reproducibility, and adequate correlation with the 10-item Eating Assessment Tool (EAT-10).

Conclusion

Evaluation of the DYMUS resulted in a shortened version of the questionnaire with five questions related to dysphagia. This shortened version is considered an easy and useful tool in identifying patients with MS-related dysphagia.

Keywords

Dysphagia Deglutition Multiple sclerosis Questionnaire Validation 

Notes

Acknowledgements

The authors gratefully acknowledge Therese Burke and Linda Mekhael for their contribution and support during the data collection phase of the study.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article. Al Ali was supported by a scholarship from Kuwait University, and Ballard was supported by Australian Research Council Future Fellowship FT120100355.

Compliance with Ethical Standards

Conflict of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

References

  1. 1.
    Tassorelli C, et al. Dysphagia in multiple sclerosis: from pathogenesis to diagnosis. Neurological Sciences. 2008;29(Suppl 4):S360–3.CrossRefPubMedGoogle Scholar
  2. 2.
    Hartelius L, Svensson P. Speech and swallowing symptoms associated with parkinsons-disease and multiple-sclerosis—a survey. Folia Phoniatrica Et Logopaedica. 1994;46(1):9–17.CrossRefPubMedGoogle Scholar
  3. 3.
    Prosiegel M, Schelling A, Wagner-Sonntag E. Dysphagia and multiple sclerosis. Int Ms J. 2004;11(1):22–31.PubMedGoogle Scholar
  4. 4.
    Leder SB, Novella S, Patwa H. Use of fiberoptic endoscopic evaluation of swallowing (FEES) in patients with amyrotrophic lateral sclerosis. Dysphagia. 2004;19(3):177–81.CrossRefPubMedGoogle Scholar
  5. 5.
    Belafsky PC, et al. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919–24.CrossRefPubMedGoogle Scholar
  6. 6.
    Poorjavad M, et al. Oropharyngeal dysphagia in multiple sclerosis. Mult Scler. 2010;16(3):362–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Bergamaschi R, et al. Validation of the DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. Funct Neurol. 2009;24(3):159–62.PubMedGoogle Scholar
  8. 8.
    Sales DS, et al. Translation, cross-cultural adaptation and validation of the Portuguese version of the DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. SpringerPlus. 2013;2(1):1–6.CrossRefGoogle Scholar
  9. 9.
    Orlandoni P, Jukic P. Health-related quality of life and functional health status questionnaires in oropharyngeal dysphagia. J Aging Res Clin Pract. 2016;5(1):31–7.Google Scholar
  10. 10.
    Speyer R, et al. Psychometric properties of questionnaires on functional health status in oropharyngeal dysphagia: a systematic literature review. Biomed Res Int. 2014;2014:1–11.CrossRefGoogle Scholar
  11. 11.
    Bergamaschi R, et al. The DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. J Neurol Sci. 2008;269(1):49–53.CrossRefPubMedGoogle Scholar
  12. 12.
    Terwee CB, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.CrossRefPubMedGoogle Scholar
  13. 13.
    Cordier R, et al. Evaluating the psychometric properties of the Eating Assessment Tool (EAT-10) using Rasch analysis. Dysphagia. 2017;32(2):250–60.CrossRefPubMedGoogle Scholar
  14. 14.
    Möller R, Safa S, Östberg P. Validation of the Swedish translation of eating assessment tool (S-EAT-10). Acta Otolaryngol. 2016;136(7):749–53.CrossRefPubMedGoogle Scholar
  15. 15.
    Demir N, et al. Reliability and validity of the Turkish Eating Assessment Tool (T-EAT-10). Dysphagia. 2016;31:644–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Rolstad S, Adler J, Rydén A. Response burden and questionnaire length: is shorter better? A review and meta-analysis. Value Health. 2011;14(8):1101–8.CrossRefPubMedGoogle Scholar
  17. 17.
    McHorney CA, et al. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: II. Item reduction and preliminary scaling. Dysphagia. 2000;15(3):122–33.CrossRefPubMedGoogle Scholar
  18. 18.
    World Medical Association. World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRefGoogle Scholar
  19. 19.
    Verma K. Base of a research: good clinical practice in clinical trials. J Clin Trials. 2013;3(1):100–28.CrossRefGoogle Scholar
  20. 20.
    Cheney DM, et al. The Ability of the 10-Item Eating Assessment Tool (EAT-10) to predict aspiration risk in persons with dysphagia. Ann Otol Rhinol Laryngol. 2015;124(5):351–4.CrossRefPubMedGoogle Scholar
  21. 21.
    Nogueira DS, et al. Measuring outcomes for dysphagia: validity and reliability of the European Portuguese Eating Assessment Tool (P-EAT-10). Dysphagia. 2015;30(5):511–20.CrossRefPubMedGoogle Scholar
  22. 22.
    Bland JM, Altman DG. Cronbach’s alpha. BMJ (Clinical research ed.). 1997;314(7080):572.CrossRefGoogle Scholar
  23. 23.
    Altman DG. Practical statistics for medical research. New York: Chapman and Hall; 1991.Google Scholar
  24. 24.
    McHorney CA, et al. The SWAL–QOL and SWAL–CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia. 2002;17(2):97–114.CrossRefPubMedGoogle Scholar
  25. 25.
    Ratner B. The correlation coefficient: its values range between + 1 − 1, or do they? J Target Meas Anal Mark. 2009;17(2):139–42.CrossRefGoogle Scholar
  26. 26.
    Orton S-M, et al. Sex ratio of multiple sclerosis in Canada: a longitudinal study. Lancet Neurol. 2006;5(11):932–6.CrossRefPubMedGoogle Scholar
  27. 27.
    Corso MJ, et al. Globus sensation is associated with hypertensive upper esophageal sphincter but not with gastroesophageal reflux. Dig Dis Sci. 1998;43(7):1513–7.CrossRefPubMedGoogle Scholar
  28. 28.
    Habek M, Hojsak I, Brinar VV. Nutrition in multiple sclerosis. Clin Neurol Neurosurg. 2010;112(7):616–20.CrossRefPubMedGoogle Scholar
  29. 29.
    Schwarz S, Leweling H. Multiple sclerosis and nutrition. Mult Scler. 2005;11(1):24–32.CrossRefPubMedGoogle Scholar
  30. 30.
    McMahon SR, et al. Comparison of e-mail, fax, and postal surveys of pediatricians. Pediatrics. 2003;111(4):e299–303.CrossRefPubMedGoogle Scholar
  31. 31.
    Schleyer TK, Forrest JL. Methods for the design and administration of web-based surveys. JAMIA. 2000;7(4):416–25.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Suresh K, Chandrashekara S. Sample size estimation and power analysis for clinical research studies. J Human Reprod Sci. 2012;5(1):7–13.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Dalal Alali
    • 1
  • Kirrie Ballard
    • 2
  • Steve Vucic
    • 3
  • Hans Bogaardt
    • 4
  1. 1.University of SydneyLidcombeAustralia
  2. 2.University of SydneyLidcombeAustralia
  3. 3.Westmead HospitalWestmeadAustralia
  4. 4.University of SydneyLidcombeAustralia

Personalised recommendations