Rafaela Soares Rech1, Fernando Neves Hugo1,2, Alexandre Baumgarten3, Karoline Weber Dos Santos4, Bárbara Niegia Garcia de Goulart3,5, Juliana Balbinot Hilgert1,3,6. 1. Graduate Studies Program in Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. 2. Center of Social Dentistry Research, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. 3. Graduate Studies Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. 4. Cristo Redentor Hospital, Conceição Hospital Group, Porto Alegre, Brazil. 5. Department of Health and Human Communication, Institute of Psychology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. 6. Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Abstract
OBJECTIVE: This study aimed to evaluate the diagnostic accuracy of a simplified clinical examination of swallowing by dentists and the Eating Assessment Tool (EAT-10), when compared with the diagnosis provided by a speech pathologist (gold standard). METHODS: Three dentists and 1 speech pathologist clinically evaluated 265 older persons in southern Brazil, 123 were residents in long-term care and 142 were community-dwelling, all able to respond to the research protocol independently. Accuracy, sensitivity, specificity, positive and negative predictive values (+PV and -PV), and positive and negative likelihood ratios (+LR and -LR) were calculated according to standard methods. This study was approved by the Ethics Committee of the Federal University of Rio Grande do Sul. RESULTS: Mean age of the participants was 73.5 (±8.9) years and most of them were women (N = 157, 59.2%). The prevalence of dysphagia as diagnosed by a speech pathologist was 45.3%. The accuracy of diagnosis was 0.84 for the clinical examination of swallowing by dentists. Furthermore, sensitivity was 0.77, specificity was 0.89, +PV was 0.85, -PV was 0.83, +LR was 7.02 and -LR was 0.25. The accuracy of EAT-10 was 0.72, the sensitivity was 0.45, specificity was 0.94, +PV was 0.87, -PV was 0.67, +LR was 8.31 and -LR was 0.57. CONCLUSIONS: Simplified clinical examination of swallowing by dentists was found to be an accurate method to screen dysphagia in older persons.
OBJECTIVE: This study aimed to evaluate the diagnostic accuracy of a simplified clinical examination of swallowing by dentists and the Eating Assessment Tool (EAT-10), when compared with the diagnosis provided by a speech pathologist (gold standard). METHODS: Three dentists and 1 speech pathologist clinically evaluated 265 older persons in southern Brazil, 123 were residents in long-term care and 142 were community-dwelling, all able to respond to the research protocol independently. Accuracy, sensitivity, specificity, positive and negative predictive values (+PV and -PV), and positive and negative likelihood ratios (+LR and -LR) were calculated according to standard methods. This study was approved by the Ethics Committee of the Federal University of Rio Grande do Sul. RESULTS: Mean age of the participants was 73.5 (±8.9) years and most of them were women (N = 157, 59.2%). The prevalence of dysphagia as diagnosed by a speech pathologist was 45.3%. The accuracy of diagnosis was 0.84 for the clinical examination of swallowing by dentists. Furthermore, sensitivity was 0.77, specificity was 0.89, +PV was 0.85, -PV was 0.83, +LR was 7.02 and -LR was 0.25. The accuracy of EAT-10 was 0.72, the sensitivity was 0.45, specificity was 0.94, +PV was 0.87, -PV was 0.67, +LR was 8.31 and -LR was 0.57. CONCLUSIONS: Simplified clinical examination of swallowing by dentists was found to be an accurate method to screen dysphagia in older persons.