Sensitivity and specificity of the Eating Assessment Tool and the Volume‐Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia
Background Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to determine the accuracy of the Eating Assessment Tool (EAT‐10) and the Volume‐Viscosity Swallow Test (V‐VST) for clinical evaluation of OD. Meth...
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| Vydané v: | Neurogastroenterology and motility Ročník 26; číslo 9; s. 1256 - 1265 |
|---|---|
| Hlavní autori: | , , , |
| Médium: | Journal Article |
| Jazyk: | English |
| Vydavateľské údaje: |
England
Wiley Subscription Services, Inc
01.09.2014
BlackWell Publishing Ltd |
| Predmet: | |
| ISSN: | 1350-1925, 1365-2982, 1365-2982 |
| On-line prístup: | Získať plný text |
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| Abstract | Background
Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to determine the accuracy of the Eating Assessment Tool (EAT‐10) and the Volume‐Viscosity Swallow Test (V‐VST) for clinical evaluation of OD.
Methods
We studied 120 patients with swallowing difficulties and 14 healthy subjects. OD was evaluated by the 10‐item screening questionnaire EAT‐10 and the bedside method V‐VST, videofluoroscopy (VFS) being the reference standard. The V‐VST is an effort test that uses boluses of different volumes and viscosities to identify clinical signs of impaired efficacy (impaired labial seal, piecemeal deglutition, and residue) and impaired safety of swallow (cough, voice changes, and oxygen desaturation ≥3%). Discriminating ability was assessed by the AUC of the ROC curve and sensitivity and specificity values.
Key Results
According to VFS, prevalence of OD was 87%, 75.6% with impaired efficacy and 80.9% with impaired safety of swallow including 17.6% aspirations. The EAT‐10 showed a ROC AUC of 0.89 for OD with an optimal cut‐off at 2 (0.89 sensitivity and 0.82 specificity). The V‐VST showed 0.94 sensitivity and 0.88 specificity for OD, 0.79 sensitivity and 0.75 specificity for impaired efficacy, 0.87 sensitivity and 0.81 specificity for impaired safety, and 0.91 sensitivity and 0.28 specificity for aspirations.
Conclusions & Inferences
Clinical methods for screening (EAT‐10) and assessment (V‐VST) of OD offer excellent psychometric proprieties that allow adequate management of OD. Their universal application among at‐risk populations will improve the identification of patients with OD at risk for malnutrition and aspiration pneumonia.
Despite its high prevalence and severe complications, oropharyngeal dysphagia (OD) is not always systematically explored and detected, and most patients are not even diagnosed and do not receive any treatment for this condition. Videofluoroscopy (VFS) is the gold standard to OD diagnosis, however, it is not feasible to perform a VFS on every patient at risk for OD. The screening method Eating Assessment Tool (EAT‐10) and the clinical bedside method, Volume‐Viscosity Swallow Test (V‐VST) offer high accuracy for detecting OD. |
|---|---|
| AbstractList | Background
Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to determine the accuracy of the Eating Assessment Tool (EAT‐10) and the Volume‐Viscosity Swallow Test (V‐VST) for clinical evaluation of OD.
Methods
We studied 120 patients with swallowing difficulties and 14 healthy subjects. OD was evaluated by the 10‐item screening questionnaire EAT‐10 and the bedside method V‐VST, videofluoroscopy (VFS) being the reference standard. The V‐VST is an effort test that uses boluses of different volumes and viscosities to identify clinical signs of impaired efficacy (impaired labial seal, piecemeal deglutition, and residue) and impaired safety of swallow (cough, voice changes, and oxygen desaturation ≥3%). Discriminating ability was assessed by the AUC of the ROC curve and sensitivity and specificity values.
Key Results
According to VFS, prevalence of OD was 87%, 75.6% with impaired efficacy and 80.9% with impaired safety of swallow including 17.6% aspirations. The EAT‐10 showed a ROC AUC of 0.89 for OD with an optimal cut‐off at 2 (0.89 sensitivity and 0.82 specificity). The V‐VST showed 0.94 sensitivity and 0.88 specificity for OD, 0.79 sensitivity and 0.75 specificity for impaired efficacy, 0.87 sensitivity and 0.81 specificity for impaired safety, and 0.91 sensitivity and 0.28 specificity for aspirations.
Conclusions & Inferences
Clinical methods for screening (EAT‐10) and assessment (V‐VST) of OD offer excellent psychometric proprieties that allow adequate management of OD. Their universal application among at‐risk populations will improve the identification of patients with OD at risk for malnutrition and aspiration pneumonia.
Despite its high prevalence and severe complications, oropharyngeal dysphagia (OD) is not always systematically explored and detected, and most patients are not even diagnosed and do not receive any treatment for this condition. Videofluoroscopy (VFS) is the gold standard to OD diagnosis, however, it is not feasible to perform a VFS on every patient at risk for OD. The screening method Eating Assessment Tool (EAT‐10) and the clinical bedside method, Volume‐Viscosity Swallow Test (V‐VST) offer high accuracy for detecting OD. Background Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to determine the accuracy of the Eating Assessment Tool (EAT-10) and the Volume-Viscosity Swallow Test (V-VST) for clinical evaluation of OD. Methods We studied 120 patients with swallowing difficulties and 14 healthy subjects. OD was evaluated by the 10-item screening questionnaire EAT-10 and the bedside method V-VST, videofluoroscopy (VFS) being the reference standard. The V-VST is an effort test that uses boluses of different volumes and viscosities to identify clinical signs of impaired efficacy (impaired labial seal, piecemeal deglutition, and residue) and impaired safety of swallow (cough, voice changes, and oxygen desaturation ≥3%). Discriminating ability was assessed by the AUC of the ROC curve and sensitivity and specificity values. Key Results According to VFS, prevalence of OD was 87%, 75.6% with impaired efficacy and 80.9% with impaired safety of swallow including 17.6% aspirations. The EAT-10 showed a ROC AUC of 0.89 for OD with an optimal cut-off at 2 (0.89 sensitivity and 0.82 specificity). The V-VST showed 0.94 sensitivity and 0.88 specificity for OD, 0.79 sensitivity and 0.75 specificity for impaired efficacy, 0.87 sensitivity and 0.81 specificity for impaired safety, and 0.91 sensitivity and 0.28 specificity for aspirations. Conclusions & Inferences Clinical methods for screening (EAT-10) and assessment (V-VST) of OD offer excellent psychometric proprieties that allow adequate management of OD. Their universal application among at-risk populations will improve the identification of patients with OD at risk for malnutrition and aspiration pneumonia. [PUBLICATION ABSTRACT] Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to determine the accuracy of the Eating Assessment Tool (EAT-10) and the Volume-Viscosity Swallow Test (V-VST) for clinical evaluation of OD.BACKGROUNDOropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to determine the accuracy of the Eating Assessment Tool (EAT-10) and the Volume-Viscosity Swallow Test (V-VST) for clinical evaluation of OD.We studied 120 patients with swallowing difficulties and 14 healthy subjects. OD was evaluated by the 10-item screening questionnaire EAT-10 and the bedside method V-VST, videofluoroscopy (VFS) being the reference standard. The V-VST is an effort test that uses boluses of different volumes and viscosities to identify clinical signs of impaired efficacy (impaired labial seal, piecemeal deglutition, and residue) and impaired safety of swallow (cough, voice changes, and oxygen desaturation ≥3%). Discriminating ability was assessed by the AUC of the ROC curve and sensitivity and specificity values.METHODSWe studied 120 patients with swallowing difficulties and 14 healthy subjects. OD was evaluated by the 10-item screening questionnaire EAT-10 and the bedside method V-VST, videofluoroscopy (VFS) being the reference standard. The V-VST is an effort test that uses boluses of different volumes and viscosities to identify clinical signs of impaired efficacy (impaired labial seal, piecemeal deglutition, and residue) and impaired safety of swallow (cough, voice changes, and oxygen desaturation ≥3%). Discriminating ability was assessed by the AUC of the ROC curve and sensitivity and specificity values.According to VFS, prevalence of OD was 87%, 75.6% with impaired efficacy and 80.9% with impaired safety of swallow including 17.6% aspirations. The EAT-10 showed a ROC AUC of 0.89 for OD with an optimal cut-off at 2 (0.89 sensitivity and 0.82 specificity). The V-VST showed 0.94 sensitivity and 0.88 specificity for OD, 0.79 sensitivity and 0.75 specificity for impaired efficacy, 0.87 sensitivity and 0.81 specificity for impaired safety, and 0.91 sensitivity and 0.28 specificity for aspirations.KEY RESULTSAccording to VFS, prevalence of OD was 87%, 75.6% with impaired efficacy and 80.9% with impaired safety of swallow including 17.6% aspirations. The EAT-10 showed a ROC AUC of 0.89 for OD with an optimal cut-off at 2 (0.89 sensitivity and 0.82 specificity). The V-VST showed 0.94 sensitivity and 0.88 specificity for OD, 0.79 sensitivity and 0.75 specificity for impaired efficacy, 0.87 sensitivity and 0.81 specificity for impaired safety, and 0.91 sensitivity and 0.28 specificity for aspirations.Clinical methods for screening (EAT-10) and assessment (V-VST) of OD offer excellent psychometric proprieties that allow adequate management of OD. Their universal application among at-risk populations will improve the identification of patients with OD at risk for malnutrition and aspiration pneumonia.CONCLUSIONS & INFERENCESClinical methods for screening (EAT-10) and assessment (V-VST) of OD offer excellent psychometric proprieties that allow adequate management of OD. Their universal application among at-risk populations will improve the identification of patients with OD at risk for malnutrition and aspiration pneumonia. Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to determine the accuracy of the Eating Assessment Tool (EAT-10) and the Volume-Viscosity Swallow Test (V-VST) for clinical evaluation of OD. We studied 120 patients with swallowing difficulties and 14 healthy subjects. OD was evaluated by the 10-item screening questionnaire EAT-10 and the bedside method V-VST, videofluoroscopy (VFS) being the reference standard. The V-VST is an effort test that uses boluses of different volumes and viscosities to identify clinical signs of impaired efficacy (impaired labial seal, piecemeal deglutition, and residue) and impaired safety of swallow (cough, voice changes, and oxygen desaturation greater than or equal to 3%). Discriminating ability was assessed by the AUC of the ROC curve and sensitivity and specificity values. According to VFS, prevalence of OD was 87%, 75.6% with impaired efficacy and 80.9% with impaired safety of swallow including 17.6% aspirations. The EAT-10 showed a ROC AUC of 0.89 for OD with an optimal cut-off at 2 (0.89 sensitivity and 0.82 specificity). The V-VST showed 0.94 sensitivity and 0.88 specificity for OD, 0.79 sensitivity and 0.75 specificity for impaired efficacy, 0.87 sensitivity and 0.81 specificity for impaired safety, and 0.91 sensitivity and 0.28 specificity for aspirations. Clinical methods for screening (EAT-10) and assessment (V-VST) of OD offer excellent psychometric proprieties that allow adequate management of OD. Their universal application among at-risk populations will improve the identification of patients with OD at risk for malnutrition and aspiration pneumonia. Despite its high prevalence and severe complications, oropharyngeal dysphagia (OD) is not always systematically explored and detected, and most patients are not even diagnosed and do not receive any treatment for this condition. Videofluoroscopy (VFS) is the gold standard to OD diagnosis, however, it is not feasible to perform a VFS on every patient at risk for OD. The screening method Eating Assessment Tool (EAT-10) and the clinical bedside method, Volume-Viscosity Swallow Test (V-VST) offer high accuracy for detecting OD. Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to determine the accuracy of the Eating Assessment Tool (EAT-10) and the Volume-Viscosity Swallow Test (V-VST) for clinical evaluation of OD. We studied 120 patients with swallowing difficulties and 14 healthy subjects. OD was evaluated by the 10-item screening questionnaire EAT-10 and the bedside method V-VST, videofluoroscopy (VFS) being the reference standard. The V-VST is an effort test that uses boluses of different volumes and viscosities to identify clinical signs of impaired efficacy (impaired labial seal, piecemeal deglutition, and residue) and impaired safety of swallow (cough, voice changes, and oxygen desaturation ≥3%). Discriminating ability was assessed by the AUC of the ROC curve and sensitivity and specificity values. According to VFS, prevalence of OD was 87%, 75.6% with impaired efficacy and 80.9% with impaired safety of swallow including 17.6% aspirations. The EAT-10 showed a ROC AUC of 0.89 for OD with an optimal cut-off at 2 (0.89 sensitivity and 0.82 specificity). The V-VST showed 0.94 sensitivity and 0.88 specificity for OD, 0.79 sensitivity and 0.75 specificity for impaired efficacy, 0.87 sensitivity and 0.81 specificity for impaired safety, and 0.91 sensitivity and 0.28 specificity for aspirations. Clinical methods for screening (EAT-10) and assessment (V-VST) of OD offer excellent psychometric proprieties that allow adequate management of OD. Their universal application among at-risk populations will improve the identification of patients with OD at risk for malnutrition and aspiration pneumonia. |
| Author | Rofes, L. Arreola, V. Mukherjee, R. Clavé, P. |
| Author_xml | – sequence: 1 givenname: L. surname: Rofes fullname: Rofes, L. organization: Instituto de Salud Carlos III – sequence: 2 givenname: V. surname: Arreola fullname: Arreola, V. organization: Universitat Autònoma de Barcelona – sequence: 3 givenname: R. surname: Mukherjee fullname: Mukherjee, R. organization: Nestec Ltd – sequence: 4 givenname: P. surname: Clavé fullname: Clavé, P. organization: Universitat Autònoma de Barcelona |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24909661$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | 2014 The Authors. Neurogastroenterology & Motility published by John Wiley & Sons Ltd. Copyright © 2014 John Wiley & Sons Ltd 2014 The Authors. Neurogastroenterology & Motility published by John Wiley & Sons Ltd. 2014 |
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| DOI | 10.1111/nmo.12382 |
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Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to... Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to determine the... Background Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to... |
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| SubjectTerms | Adult Aged Aged, 80 and over Deglutition deglutition disorders Deglutition Disorders - diagnosis Deglutition Disorders - physiopathology Dysphagia Eating Female Humans Male Middle Aged Original ROC curve screening sensitivity Sensitivity and Specificity Severity of Illness Index specificity Viscosity |
| Title | Sensitivity and specificity of the Eating Assessment Tool and the Volume‐Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia |
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