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Reliability and Validity Analyses of the Practical Assessment of Dysphagia Test in Stroke

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Abstract

To investigate the validity and reliability of the Practical Assessment of Dysphagia (PAD) test as a quantitative and organ-specific test for stroke patients. In this study, PAD test data from 109 patients with stroke were used. The internal consistency of the PAD was analyzed using Cronbach’s α value. Inter- and intra-rater reliabilities of the PAD were analyzed using Kappa coefficient. Concurrent validity was evaluated based on the correlation between PAD and the videofluoroscopic swallowing study (VFSS). The diagnostic accuracy of the PAD test in patients with stroke was measured using the area under the receiver operating characteristic (ROC) curve. Intra- and inter-rater reliabilities (Intra-class Correlation Coefficient (ICC) = 0.98 and 0.99, respectively) were significant (p < 0.001) for the total PAD score. The functional dysphagia scale (FDS) score and penetration-aspiration score (PAS) correlated significantly with PAD (p < 0.001). The results of the ROC curve analysis with various cut-off points showed that the PAD test had high sensitivity and specificity. The PAD has high reliability and validity. Therefore, it is a useful screening test for dysphagia in patients with stroke.

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Data Availability

The datasets generated during the current study are not publicly available since they will contain patient data and the informed consent does not include sharing-data publicly. The datasets are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, 776, 1 Sunhwan-ro, Seowon-gu, Cheongju, 28644, Republic of Korea

    Han Tae Kim MD & Hyo Jong Kim MD, PhD

  2. Department of Clinical Pharmacology and Therapeutics, Chungbuk National University Hospital, 776, 1 Sunhwan-ro, Seowon-gu, Cheongju, 28644, Republic of Korea

    Hyo-Jin Min

  3. Department of Medicine, Chungbuk National University Graduate School, Chungdae-ro 1, Seowon-Gu, Cheongju, 28644, Republic of Korea

    Hyo-Jin Min

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Contributions

This study was designed by HJ Kim. HJ Kim acted as a consultant and monitored the research process. Data collection was completed by HT Kim who also drafted the article. HJ Min completed statistical analysis, and interpretation. HJ Kim and HT Kim critically read the article and revised it for the final draft. The final version of the article was approved by all the authors.

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Correspondence to Hyo Jong Kim MD, PhD.

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Ethical Approval

Ethical approval was obtained from the Institutional Review Board (IRB) of the Chungbuk National University Hospital (CBNUH 2022-06-012-002).

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The authors declare that they have no conflicts of interest concerning this research.

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Informed Consent was obtained from participants included in this study.

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Kim, H.T., Min, HJ. & Kim, H.J. Reliability and Validity Analyses of the Practical Assessment of Dysphagia Test in Stroke. Dysphagia (2024). https://doi.org/10.1007/s00455-024-10708-z

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