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Validation of a swallowing disturbance questionnaire for detecting dysphagia in patients with Parkinson's disease

Authors

  • Yael Manor MA,

    Corresponding author
    1. Department of Neurology, Movement Disorders Unit, Parkinson Center, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
    2. Voice and Swallowing Disorders Clinic, Department of Otolaryngology Head and Neck Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
    • Movement Disorders Unit, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv, Israel 642359
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  • Nir Giladi MD,

    1. Department of Neurology, Movement Disorders Unit, Parkinson Center, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
    2. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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  • Alma Cohen PhD,

    1. The Berglas School of Economics, Tel-Aviv University, Tel-Aviv, Israel
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  • Dan M. Fliss MD,

    1. Voice and Swallowing Disorders Clinic, Department of Otolaryngology Head and Neck Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
    2. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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  • Jacob T. Cohen MD

    1. Voice and Swallowing Disorders Clinic, Department of Otolaryngology Head and Neck Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
    2. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Abstract

Underreporting of swallowing disturbances by Parkinson's disease (PD) patients may lead to delay in diagnosis and treatment, alerting the physician to an existing dysphagia only after the first episode of aspiration pneumonia. We developed and validated a swallowing disturbance questionnaire (SDQ) for PD patients and compared its findings to an objective assessment. Fifty-seven PD patients (mean age 69 ± 10 years) participated in this study. Each patient was queried about experiencing swallowing disturbances and asked to complete a self-reported 15-item “yes/no” questionnaire on swallowing disturbances (24 replied “no”). All study patients underwent a physical/clinical swallowing evaluation by a speech pathologist and an otolaryngologist. The 33 patients who complained of swallowing disturbances also underwent fiberoptic endoscopyic evaluation of swallowing (FEES). According to the ROC test, the “optimal” score (where the sensitivity and specificity curves cross) is 11 (sensitivity 80.5%, specificity 81.3%). Using the SDQ questionnaire substantially reduced Type I errors (specifically, an existing swallowing problem missed by the selected cutoff point). On the basis of the SDQ assessment alone, 12 of the 24 (50%) noncomplaining patients would have been referred to further evaluation that they otherwise would not have undergone. The SDQ emerged as a validated tool to detect early dysphagia in PD patients. © 2007 Movement Disorder Society

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