S Miller1, D Kühn, M Jungheim, M Ptok. 1. Klinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, MHH OE 6510, 30623, Hannover, Deutschland, Miller.Simone@mh-hannover.de.
Abstract
BACKGROUND: The requirement for otorhinolaryngologists and phoniatricians to diagnose dysphagia and evaluate its extent is on the rise, particularly in light of demographic changes. The gold standards in confirmatory diagnostics are fiberoptic endoscopic evaluation of swallowing (FEES) and the videofluoroscopic swallowing examination (VFS). Standardized assessments, such as questionnaires or assessments involving probatory swallows are often applied as screening or supportive measures. This article aims to give a critical overview of the assessment tools frequently used in clinical routine. Test quality is assessed, particularly compared to FEES and VFS. METHODS: A selective literature search using PubMed has been conducted. RESULTS: On the basis of this lierature search, 48 assessment tools were identified. These can be classified into screening tools, instrument-based tools (implementation standards and evaluation protocols) and questionnaire-based assessment inventories. DISCUSSION: In order to diagnose and evaluate dysphagia on the basis of assessment critieria, clinicians should be aware of indications for, as well as the advantages, disadvantages and test quality of the assessment tools. Considering the different assessment tools for anamnesis and probatory swallowing, rather low sensitivities and specificities for possible penetration and aspiration are evident. In cases where these symptoms of dysphagia are not evident and reliably assessable, confirmatory assessment via FEES or VFS is essential.
BACKGROUND: The requirement for otorhinolaryngologists and phoniatricians to diagnose dysphagia and evaluate its extent is on the rise, particularly in light of demographic changes. The gold standards in confirmatory diagnostics are fiberoptic endoscopic evaluation of swallowing (FEES) and the videofluoroscopic swallowing examination (VFS). Standardized assessments, such as questionnaires or assessments involving probatory swallows are often applied as screening or supportive measures. This article aims to give a critical overview of the assessment tools frequently used in clinical routine. Test quality is assessed, particularly compared to FEES and VFS. METHODS: A selective literature search using PubMed has been conducted. RESULTS: On the basis of this lierature search, 48 assessment tools were identified. These can be classified into screening tools, instrument-based tools (implementation standards and evaluation protocols) and questionnaire-based assessment inventories. DISCUSSION: In order to diagnose and evaluate dysphagia on the basis of assessment critieria, clinicians should be aware of indications for, as well as the advantages, disadvantages and test quality of the assessment tools. Considering the different assessment tools for anamnesis and probatory swallowing, rather low sensitivities and specificities for possible penetration and aspiration are evident. In cases where these symptoms of dysphagia are not evident and reliably assessable, confirmatory assessment via FEES or VFS is essential.
Authors: Colleen A McHorney; Joanne Robbins; Kevin Lomax; John C Rosenbek; Kimberly Chignell; Amy E Kramer; D Earl Bricker Journal: Dysphagia Date: 2002 Impact factor: 3.438