| 1. |
- Waqas, Muhammad, 1983, et al.
(författare)
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Assessment of the Food-Swallowing Process Using Bolus Visualisation and Manometry Simultaneously in a Device that Models Human Swallowing
- 2019
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Ingår i: Dysphagia. - : Springer Science and Business Media LLC. - 0179-051X .- 1432-0460. ; 34:6, s. 821-833
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Forskningsöversikt (refereegranskat)abstract
- The characteristics of the flows of boluses with different consistencies, i.e. different rheological properties, through the pharynx have not been fully elucidated. The results obtained using a novel in vitro device, the Gothenburg Throat, which allows simultaneous bolus flow visualisation and manometry assessments in the pharynx geometry, are presented, to explain the dependence of bolus flow on bolus consistency. Four different bolus consistencies of a commercial food thickener, 0.5, 1, 1.5 and 2 Pa s (at a shear rate of 50 s −1 )—corresponding to a range from low honey-thick to pudding-thick consistencies on the National Dysphagia Diet (NDD) scale—were examined in the in vitro pharynx. The bolus velocities recorded in the simulator pharynx were in the range of 0.046–0.48 m/s, which is within the range reported in clinical studies. The corresponding wall shear rates associated with these velocities ranged from 13 s −1 (pudding consistency) to 209 s −1 (honey-thick consistency). The results of the in vitro manometry tests using different consistencies and bolus volumes were rather similar to those obtained in clinical studies. The in vitro device used in this study appears to be a valuable tool for pre-clinical analyses of thickened fluids. Furthermore, the results show that it is desirable to consider a broad range of shear rates when assessing the suitability of a certain consistency for swallowing.
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| 2. |
- Albinsson, Sofie, 1992, et al.
(författare)
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Patient-Reported Dysphagia in Adults with Eosinophilic Esophagitis: Translation and Validation of the Swedish Eosinophilic Esophagitis Activity Index
- 2022
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Ingår i: Dysphagia. - : Springer Science and Business Media LLC. - 0179-051X .- 1432-0460. ; 37, s. 286-296
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Tidskriftsartikel (refereegranskat)abstract
- The lack of a Swedish patient-reported outcome instrument for eosinophilic esophagitis (EoE) has limited the assessment of the disease. The aims of the study were to translate and validate the Eosinophilic Esophagitis Activity Index (EEsAI) to Swedish and to assess the symptom severity of patients with EoE compared to a nondysphagia control group. The EEsAI was translated and adapted to a Swedish cultural context (S-EEsAI) based on international guidelines. The S-EEsAI was validated using adult Swedish patients with EoE (n = 97) and an age- and sex-matched nondysphagia control group (n = 97). All participants completed the S-EEsAI, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Oesophageal Module 18 (EORTC QLQ-OES18), and supplementary questions regarding feasibility and demographics. Reliability and validity of the S-EEsAI were evaluated by Cronbach's alpha and Spearman correlation coefficients between the domains of the S-EEsAI and the EORTC QLQ-OES18. A test-retest analysis of 29 patients was evaluated through intraclass correlation coefficients. The S-EEsAI had sufficient reliability with Cronbach's alpha values of 0.83 and 0.85 for the "visual dysphagia question" and the "avoidance, modification and slow eating score" domains, respectively. The test-retest reliability was sufficient, with good to excellent intraclass correlation coefficients (0.60-0.89). The S-EEsAI domains showed moderate correlation to 6/10 EORTC QLQ-OES18 domains, indicating adequate validity. The patient S-EEsAI results differed significantly from those of the nondysphagia controls (p < 0.001). The S-EEsAI appears to be a valid and reliable instrument for monitoring adult patients with EoE in Sweden.
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| 3. |
- Backman, Jan, et al.
(författare)
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Species-specific responses of late Miocene Discoaster spp. to enhanced biosilica productivity conditions in the equatorial Pacific and the Mediterranean
- 2013
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Ingår i: Geo-Marine Letters. - : Springer Science and Business Media LLC. - 0276-0460 .- 1432-1157. ; 33:4, s. 285-298
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Tidskriftsartikel (refereegranskat)abstract
- Census data of a major Cenozoic calcareous nannofossil genus (Discoaster) have been acquired from Site U1338, located near the Equator in the eastern Pacific Ocean and drilled in 2009 during Integrated Ocean Drilling Program (IODP) Expedition 321. The investigated 147.53 m thick upper Miocene sediment sequence is primarily composed of biogenic carbonate and biogenic silica. Diatom biostratigraphic data were used to develop a revised biomagnetostratigraphic age model, resulting in more variable late Miocene sedimentation rates. Carbonate content variations mainly reflect dilution by biogenic silica production, although intense carbonate dissolution affects a few shorter intervals. Abundance variations of discoasters show no distinct correlation with either carbonate or biosilica contents. The two dominant Discoaster taxa are D. brouweri and D. variabilis, except for a 12 m thick interval where D. bellus outnumbers the sum of all other discoasters by a factor of 4.6. Data presented indicate that first D. hamatus and then D. berggrenii both evolved from D. bellus. Three unusual morphotypes, here referred to as Discoaster A, B and C, increase in relative abundance during episodes of enhanced biosilica production in the upper half of the investigated sequence (Messinian). Strikingly similar morphotypes have been observed previously in Messinian age sediments from the Mediterranean, characterized by alternating deposition of biogenic carbonate and biosilica. This suggests a species-specific response among some of the late Miocene discoasters to broader oceanographic and climatic forcing that promoted episodes of enhanced deposition of biogenic silica.
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| 4. |
- Bülow, Margareta, et al.
(författare)
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Neuromuscular Electrical Stimulation (NMES) in Stroke Patients with Oral and Pharyngeal Dysfunction.
- 2008
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Ingår i: Dysphagia. - : Springer Science and Business Media LLC. - 1432-0460 .- 0179-051X. ; 23, s. 302-309
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Tidskriftsartikel (refereegranskat)abstract
- Neuromuscular electrical stimulation (NMES) technique is a dual-channel electrotherapy system designed specifically for the treatment of pharyngeal dysfunction. The purpose of this study was to evaluate and compare the outcome of NMES versus traditional swallowing therapy (TT) in stroke patients. Three European swallowing centers participated in this randomized trial. Twenty-five patients (16 men and 9 women) were included. Twelve patients were randomized for NMES and 13 for TT. Mean age was 70 years for the NMES group and 71 years for the TT group. Inclusion criteria were (1) patients 50-80 years old with cerebrovascular disease (stroke) for more than 3 months before the study, (2) only patients with hemispheric stroke, (3) no brainstem involvement, (4) ability to swallow, and (5) ability to communicate. Pre- and post-trial measurements were videoradiographic swallowing evaluation, nutritional status, oral motor function test, and a visual analog scale (VAS) for self-evaluation of complaints. All subjects received 15 therapy sessions. Statistically significant positive therapy effects for both NMES and TT combined were found, but there was no statistically significant difference in therapy effect between the groups. The correlations between measurements were low. The patient's subjective experience of improvement had low correlation with the outcome from the objective evaluation.
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| 5. |
- Bülow, Margareta, et al.
(författare)
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Supraglottic swallow, effortful swallow, and chin tuck did not alter hypopharyngeal intrabolus pressure in patients with pharyngeal dysfunction.
- 2002
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Ingår i: Dysphagia. - : Springer Science and Business Media LLC. - 1432-0460 .- 0179-051X. ; 17:3, s. 197-201
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Tidskriftsartikel (refereegranskat)abstract
- Simultaneous videoradiography and solid-state manometry (videomanometry) were performed in 8 patients (4 women, 4 men; age range = 46-81 years, mean age = 70 years) with pharyngeal dysfunction in order to disclose any changes in intrabolus pressure during swallowing maneuvers. Five of the patients had severe pharyngeal dysfunction with frequent misdirected swallows. Three of the patients had moderate pharyngeal dysfunction with delayed initiation of pharyngeal swallow. Three different swallowing techniques were applied: supraglottic swallow, effortful swallow, and chin tuck. Pharyngeal intrabolus pressure was analyzed at the level of the inferior pharyngeal constrictor. Supraglottic swallow, effortful swallow, and chin tuck did not alter peak amplitude or duration of the intrabolus pressure.
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| 6. |
- Bülow, Margareta, et al.
(författare)
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Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in healthy volunteers
- 1999
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Ingår i: Dysphagia. - 1432-0460. ; 14:2, s. 67-72
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Tidskriftsartikel (refereegranskat)abstract
- Simultaneous videoradiography and solid-state manometry (videomanometry) was applied in eight healthy volunteers (four women, four men; age range 25-64 years, mean age 41 years) without swallowing problems. Three different swallowing techniques were tested; supraglottic swallow, effortful swallow, and chin tuck. Seven videoradiographic variables and six manometric variables were analyzed. The supraglottic swallowing technique did not differ significantly from that of the control swallows. The effortful swallow had a significantly (p = 0.0001) reduced hyoid-mandibular distance preswallow due to an elevation of the hyoid and the larynx, which caused a significantly (p = 0.007) reduced maximal hyoid movement and a significantly (p = 0.009) reduced laryngeal elevation during swallow. The chin tuck swallow had a significantly (p = 0. 001) reduced laryngohyoid distance and also a significantly (p = 0. 004) reduced hyoid-mandibular distance. The chin tuck swallow also displayed significantly (p = 0.003) weaker pharyngeal contractions. Videomanometry allows for analysis of bolus transport, movement of anatomical structures, and measurement of intraluminal pressures. These variables are important when evaluating swallowing techniques. In the present study, we made a few observations that never have been reported before. When healthy volunteers performed supraglottic swallow, they performed the technique somewhat differently. Therefore, we assume dysphagic patients would need a substantial period of training to perform a technique efficiently. Chin tuck could impair protection of the airways in dysphagic patients with weak pharyngeal constrictor muscles.
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| 7. |
- Bülow, Margareta, et al.
(författare)
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Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in patients with pharyngeal dysfunction
- 2001
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Ingår i: Dysphagia. - : Springer Science and Business Media LLC. - 1432-0460 .- 0179-051X. ; 16:3, s. 190-195
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Tidskriftsartikel (refereegranskat)abstract
- Simultaneous videoradiography and solid-state manometry (videomanometry) was performed in 8 patients (4 women, 4 men; age range = 46-81 years, mean age = 70 years) with pharyngeal dysfunction. Five patients had severe pharyngeal dysfunction with frequent misdirected swallows. Three patients had moderate pharyngeal dysfunction with delayed initiation of pharyngeal swallow. Three different swallowing techniques were used: supraglottic swallow, effortful swallow, and chin tuck. Ten video radiographic variables and six manometric variables were analyzed. Contrast media penetration to the airways was analyzed regarding number of events and level of penetration. Supraglottic swallow, effortful swallow, and chin tuck did not reduce the number of misdirected swallows, but effortful swallow and chin tuck significantly (p = 0.008) reduced the depth of contrast penetration into the larynx and trachea. There was no significant improvement of pharyngeal retention. Chin tuck reduced the distance between the thyroid and the hyoid and the distance between the mandible and the hyoid. No other measured variable was significantly altered. This study shows that none of the different swallowing techniques reduced the number of misdirected swallows. However, there was a significantly reduced depth of the misdirected swallows. The swallowing techniques did not seem to prevent the occurrence of retention or improve weak pharyngeal constrictor muscles in this group of patients with severe to moderate dysfunction.
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| 8. |
- Carlsson, Sigrid, 1982, et al.
(författare)
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Validation of the Swedish M. D. Anderson Dysphagia Inventory (MDADI) in Patients with Head and Neck Cancer and Neurologic Swallowing Disturbances.
- 2012
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Ingår i: Dysphagia. - : Springer Science and Business Media LLC. - 1432-0460 .- 0179-051X. ; 27:3, s. 361-369
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to validate the Swedish version of the dysphagia-specific quality-of-life questionnaire, the M. D. Anderson Dysphagia Inventory (MDADI). Patients with oropharyngeal dysphagia due to neurologic disease (n=30) and head and neck (H&N) cancer patients with post-treatment subjective dysphagia (n=85) were compared to an age- and gender-matched nondysphagic control group (n=115). A formal forward-backward translation was performed and followed international guidelines. Validity and reliability were tested against the Short-Form 36 (SF-36) and Hospital Anxiety and Depression Scale (HADS). Internal-consistency reliability was calculated by means of Cronbach's α coefficient. Test-retest reliability was assessed by intraclass correlation (ICC). Convergent and discriminant validity were assessed by correlations between MDADI, SF-36, and HADS. Known-group validity was examined and statistically tested. Of 126 eligible patients, 115 agreed to participate (response rate=91.3%). The age of the participants ranged between 37 and 92 years. Most of the MDADI items showed good variability and only minor floor or ceiling effects in solitary items were found. The internal-consistency reliability (Cronbach's α) of the MDADI total score was 0.88 (after correction for systematic errors in the subjects' responses to two reversed questions). All estimates reached over the satisfactory >0.70 reliability standard for group-level comparison. ICC ranged between 0.83 and 0.97 in the test-retest. The mean MDADI total score was 66.9 (SD=14.7) for the H&N cancer patients, 65.0 (16.9) for the neurologic patients, and 97.5 (4.4) for the control group (P<0.001; study patients vs. controls). The MDADI was also sensitive to disease severity as measured by different food textures. The Swedish version of the MDADI showed good psychometric properties and is a valid instrument to assess dysphagia-related quality of life. It was also shown to be a reliable instrument after correction for systematic errors in the subjects' responses to two reversed questions. Its known-group validity enables the differentiation between dysphagic and nondysphagic patients for group-level research.
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| 9. |
- Cordier, R., et al.
(författare)
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Evaluating the Psychometric Properties of the Eating Assessment Tool (EAT-10) Using Rasch Analysis
- 2017
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Ingår i: Dysphagia. - : Springer Science and Business Media LLC. - 0179-051X .- 1432-0460. ; 32:2, s. 250-260
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Tidskriftsartikel (refereegranskat)abstract
- Early and reliable screening for oropharyngeal dysphagia (OD) symptoms in at-risk populations is important and a crucial first stage in effective OD management. The Eating Assessment Tool (EAT-10) is a commonly utilized screening and outcome measure. To date, studies using classic test theory methodologies report good psychometric properties, but the EAT-10 has not been evaluated using item response theory (e.g., Rasch analysis). The aim of this multisite study was to evaluate the internal consistency and structural validity and conduct a preliminary investigation of the cross-cultural validity of the EAT-10; floor and ceiling effects were also checked. Participants involved 636 patients deemed at risk of OD, from outpatient clinics in Spain, Turkey, Sweden, and Italy. The EAT-10 and videofluoroscopic and/or fiberoptic endoscopic evaluation of swallowing were used to confirm OD diagnosis. Patients with esophageal dysphagia were excluded to ensure a homogenous sample. Rasch analysis was used to investigate person and item fit statistics, response scale, dimensionality of the scale, differential item functioning (DIF), and floor and ceiling effect. The results indicate that the EAT-10 has significant weaknesses in structural validity and internal consistency. There are both item redundancy and lack of easy and difficult items. The thresholds of the rating scale categories were disordered and gender, confirmed OD, and language, and comorbid diagnosis showed DIF on a number of items. DIF analysis of language showed preliminary evidence of problems with cross-cultural validation, and the measure showed a clear floor effect. The authors recommend redevelopment of the EAT-10 using Rasch analysis.
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| 10. |
- Dahlström, Sara, et al.
(författare)
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How Valid and Reliable Is the International Dysphagia Diet Standardisation Initiative (IDDSI) When Translated into Another Language?
- 2023
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Ingår i: Dysphagia. - : Springer Science and Business Media LLC. - 0179-051X .- 1432-0460. ; 38:2, s. 667-675
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Tidskriftsartikel (refereegranskat)abstract
- Swallowing difficulties are estimated to affect 590 million people worldwide and the modification of food and fluids is considered the cornerstone of dysphagia management. Contemporary practice uses the International Dysphagia Diet Standardisation Initiative (IDDSI), however, the validity and reliability of IDDSI when translated into another language has not been investigated. This study describes the translation process and confirms the validity and reliability of IDDSI when translated into another language (Swedish). The translation used a 12-step process based on the World Health Organization recommendations. Validity was tested using Content Validity Index (CVI) based on three ratings by a panel of 10-12 experts (Dietitians and Speech-Language Pathologists [SLPs]). The translation was rated for linguistic correlation as well as understandability and applicability in a Swedish context. Inter-rater reliability was calculated using Intraclass Correlation Coefficient (ICC) from 20 SLP assessments of 10 previously published patient cases. Significant improvement (p < 0.05) of CVI between Expert Panel assessments was shown for linguistic correlation (improvement from 0.74-0.98) and understandability/applicability (improvement from 0.79-0.93 across ratings). Excellent validity (Item-CVI > 0.78 and Scale-CVI/Average > 0.8) and very high inter-rater reliability (ICC > 0.9) were demonstrated. Results show that, when using a multi-step translation process, a translated version of IDDSI (into Swedish) demonstrates high validity and reliability. This further contributes to the evidence for use of IDDSI.
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