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

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.

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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.

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Correspondence to Dalal Alali.

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

Appendices

Appendix 1: DYMUS Questionnaire

The questionnaire involves ten questions that assess dysphagia for solids and liquids in patients with MS. Patients are instructed to answer the questions with Yes or No based on their present state, with the exception of the last question, which refers to the past 6 months.

figure a

Appendix 2: EAT-10

The questionnaire involves ten questions that assess dysphagia in patients with MS. Patients are instructed to circle an answer between 0 and 4 based on what degree they experience the problem.

1. My swallowing problem has caused me to lose weight 0 1 2 3 4
2. My swallowing problem interferes with my ability to go out for meals      
3. Swallowing liquids takes extra effort      
4. Swallowing solids takes extra effort      
5. Swallowing pills takes extra effort      
6. Swallowing is painful      
7. The pleasure of eating is affected by my swallowing      
8. When I swallow food sticks in my throat      
9. I cough when I eat      
10. Swallowing is stressful      

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Alali, D., Ballard, K., Vucic, S. et al. Dysphagia in Multiple Sclerosis: Evaluation and Validation of the DYMUS Questionnaire. Dysphagia 33, 273–281 (2018). https://doi.org/10.1007/s00455-017-9864-5

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  • DOI: https://doi.org/10.1007/s00455-017-9864-5

Keywords

  • Dysphagia
  • Deglutition
  • Multiple sclerosis
  • Questionnaire
  • Validation