Nobuhide Horii1, Yoko Hasegawa2,3, Ayumi Sakuramoto-Sadakane1, Shyota Saito4, Tomoki Nanto4, Yuta Nakao4, Kazuhisa Domen5, Takahiro Ono6, Hiromitsu Kishimoto1. 1. Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya city, Hyogo, 663-8501, Japan. 2. Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya city, Hyogo, 663-8501, Japan. cem17150@hyo-med.ac.jp. 3. Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 5274, Gakkocho-dori 2-bancho, Chuo-ku, Niigata city, 951-8514, Niigata, Japan. cem17150@hyo-med.ac.jp. 4. Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine College Hospital, Nishinomiya, Hyogo, Japan. 5. Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. 6. Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 5274, Gakkocho-dori 2-bancho, Chuo-ku, Niigata city, 951-8514, Niigata, Japan.
Abstract
BACKGROUND: The aim of this study was to evaluate the validity of a dysphagia screening test (DST) in patients who have undergone resection for head and neck cancer (HNC). In addition, we examined whether or not combined effects of DSTs improve the detection accuracy of penetration/aspiration. METHODS: Thirty-six HNC patients were participated. The DST consisted of the repetitive saliva swallowing test (RSST), the water swallowing test (WST), the modified water swallowing test (MWST), the food test (FT), and tongue pressure. A videofluoroscopic swallowing study was conducted, and the penetration-aspiration scale was used for scoring. For statistical analyses, we used the receiver operating characteristic (ROC) analysis. Furthermore, the accuracy of the determination of penetration/aspiration was evaluated by combining two or three DSTs. RESULTS: The penetration/aspiration could be predicted with moderate accuracy based on MWST and FT. The area under the ROC curve (AUC) values of the MWST and FT were 0.76 (p = 0.03) and 0.80 (p = 0.050), and the sensitivity/specificity was 0.9/0.61 (MWST) and 0.8/0.8 (FT), respectively. As a result of combining 2 or 3 DSTs, the combination of "MWST and FT" was the most accurate, with an AUC of 0.87 (p = 0.02). The combination of three tests had lower accuracy than the combination of two tests. CONCLUSION: Based on our results, it is recommended that MWST or FT be used when only one type of DST is performed. In addition, the combination of two DSTs may detect aspiration patients more accurately than one alone.
BACKGROUND: The aim of this study was to evaluate the validity of a dysphagia screening test (DST) in patients who have undergone resection for head and neck cancer (HNC). In addition, we examined whether or not combined effects of DSTs improve the detection accuracy of penetration/aspiration. METHODS: Thirty-six HNC patients were participated. The DST consisted of the repetitive saliva swallowing test (RSST), the water swallowing test (WST), the modified water swallowing test (MWST), the food test (FT), and tongue pressure. A videofluoroscopic swallowing study was conducted, and the penetration-aspiration scale was used for scoring. For statistical analyses, we used the receiver operating characteristic (ROC) analysis. Furthermore, the accuracy of the determination of penetration/aspiration was evaluated by combining two or three DSTs. RESULTS: The penetration/aspiration could be predicted with moderate accuracy based on MWST and FT. The area under the ROC curve (AUC) values of the MWST and FT were 0.76 (p = 0.03) and 0.80 (p = 0.050), and the sensitivity/specificity was 0.9/0.61 (MWST) and 0.8/0.8 (FT), respectively. As a result of combining 2 or 3 DSTs, the combination of "MWST and FT" was the most accurate, with an AUC of 0.87 (p = 0.02). The combination of three tests had lower accuracy than the combination of two tests. CONCLUSION: Based on our results, it is recommended that MWST or FT be used when only one type of DST is performed. In addition, the combination of two DSTs may detect aspiration patients more accurately than one alone.
Entities:
Keywords:
Deglutition; Dysphagia; Head and neck cancer; Screening test; Videofluoroscopic swallowing study
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