Development of the Gagging Problem Assessment: a pilot study.

An accepted management strategy for gagging problems appears not to exist. A reliable and valid instrument is needed to develop an evidence based treatment for this clinical problem. The aim of this pilot study was to evaluate the reliability and validity of a newly developed measurement tool for dental gagging: the Gagging Problem Assessment (GPA). An experimental group (n = 13) comprising individuals with gagging problems, and a control group (n = 12) that had received dental care without gagging, completed a questionnaire focused on general health aspects and dental anxiety and the patient part of the GPA. The dentist part consisted of tests with increasing intrusiveness. This part was completed by two dentists. Statistical analyses concerned inter-rater reliability (Cohen's kappa) , reliability of the questionnaire (Cronbach's alpha, Pearson correlation coefficient) and the statistical difference between the GPA and two dental anxiety questionnaires (Mann-Whitney U-test, alpha = 0.05). Within the limits of this study, the findings suggested that dental gagging warranted the development of a diagnostic and evaluative instrument. Gagging appeared to be a specific problem that cannot be interpreted as some form of dental anxiety. The GPA proved to be a reliable questionnaire to assess the presence of gagging problems, with a satisfying inter-rater reliability (kappa = 0.64; s.d. = 0.16). Significant differences were noted between the experimental group and the control group. This pilot study will be followed by a confirmation study with a larger sample size, evaluated according to recently formulated quality criteria for measurement properties of health status questionnaires.