The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) Is a Valid and Low-Cost Tool for Evaluation of Dysphagia: A Gold-Standard Comparison Study

Background. Dysphagia is a predictor of mortality in Parkinson’s disease (PD). Developing alternative methods to videofluoroscopy swallowing study (VFSS) for the evaluation of dysphagia is a public health necessity. The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) is an alte...

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Main Authors: Larissa L. Branco, Sheila Trentin, Carla Helena Augustin Schwanke, Irenio Gomes, Fernanda Loureiro
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Journal of Aging Research
Online Access:http://dx.doi.org/10.1155/2019/7984635
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author Larissa L. Branco
Sheila Trentin
Carla Helena Augustin Schwanke
Irenio Gomes
Fernanda Loureiro
author_facet Larissa L. Branco
Sheila Trentin
Carla Helena Augustin Schwanke
Irenio Gomes
Fernanda Loureiro
author_sort Larissa L. Branco
collection DOAJ
description Background. Dysphagia is a predictor of mortality in Parkinson’s disease (PD). Developing alternative methods to videofluoroscopy swallowing study (VFSS) for the evaluation of dysphagia is a public health necessity. The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) is an alternative and low-cost tool for diagnosis of dysphagia, but had not been properly validated in comparison to the gold-standard method. The objective of this study was to assess the validity and reliability of the SCAS-PD. Methods. SCAS-PD was applied to 31 patients with PD, and VFSS was conducted concurrently. This clinical assessment uses different volumes and viscosities to identify signs of swallowing impairments. For validation purposes, the interclass correlation coefficient and the weighted kappa were calculated. The AUC of the ROC curve, sensitivity, and specificity values for detection of penetration/aspiration (PA) were assessed. Internal consistency was calculated by Cronbach’s alpha. Results. Fifty-one percent of patients were classified with dysphagia. SCAS-PD was differentiated between normal/functional deglutition and dysphagia with AUC 0.97, 95% CI 0.92–1.00, and an optimal cutoff at 19 (sensitivity 100% and specificity 87.5%). The internal consistency was α = 0.91 for the total score. The internal consistency of the SCAS-PD domains was oral phase (α = 0.73), pharyngeal phase (α = 0.86), and signs of PA (α = 0.95). The weighted kappa analysis demonstrated a high rate of concordance at 0.71 (p<0.001) between SCAS-PD and VFSS. Conclusions. SCAS-PD has been shown to have a good concordance with the VFSS. Considering this, SCAS-PD is highly applicable in clinical settings, since it is a simple and low-cost diagnostic tool for detecting dysphagia in PD patients.
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2090-2212
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spelling doaj-art-627b6b7579f34d15bf647a4c413e69482025-02-03T06:13:18ZengWileyJournal of Aging Research2090-22042090-22122019-01-01201910.1155/2019/79846357984635The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) Is a Valid and Low-Cost Tool for Evaluation of Dysphagia: A Gold-Standard Comparison StudyLarissa L. Branco0Sheila Trentin1Carla Helena Augustin Schwanke2Irenio Gomes3Fernanda Loureiro4Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, BrazilDepartment of Neurology, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, BrazilGraduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, BrazilGraduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, BrazilGraduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, BrazilBackground. Dysphagia is a predictor of mortality in Parkinson’s disease (PD). Developing alternative methods to videofluoroscopy swallowing study (VFSS) for the evaluation of dysphagia is a public health necessity. The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) is an alternative and low-cost tool for diagnosis of dysphagia, but had not been properly validated in comparison to the gold-standard method. The objective of this study was to assess the validity and reliability of the SCAS-PD. Methods. SCAS-PD was applied to 31 patients with PD, and VFSS was conducted concurrently. This clinical assessment uses different volumes and viscosities to identify signs of swallowing impairments. For validation purposes, the interclass correlation coefficient and the weighted kappa were calculated. The AUC of the ROC curve, sensitivity, and specificity values for detection of penetration/aspiration (PA) were assessed. Internal consistency was calculated by Cronbach’s alpha. Results. Fifty-one percent of patients were classified with dysphagia. SCAS-PD was differentiated between normal/functional deglutition and dysphagia with AUC 0.97, 95% CI 0.92–1.00, and an optimal cutoff at 19 (sensitivity 100% and specificity 87.5%). The internal consistency was α = 0.91 for the total score. The internal consistency of the SCAS-PD domains was oral phase (α = 0.73), pharyngeal phase (α = 0.86), and signs of PA (α = 0.95). The weighted kappa analysis demonstrated a high rate of concordance at 0.71 (p<0.001) between SCAS-PD and VFSS. Conclusions. SCAS-PD has been shown to have a good concordance with the VFSS. Considering this, SCAS-PD is highly applicable in clinical settings, since it is a simple and low-cost diagnostic tool for detecting dysphagia in PD patients.http://dx.doi.org/10.1155/2019/7984635
spellingShingle Larissa L. Branco
Sheila Trentin
Carla Helena Augustin Schwanke
Irenio Gomes
Fernanda Loureiro
The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) Is a Valid and Low-Cost Tool for Evaluation of Dysphagia: A Gold-Standard Comparison Study
Journal of Aging Research
title The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) Is a Valid and Low-Cost Tool for Evaluation of Dysphagia: A Gold-Standard Comparison Study
title_full The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) Is a Valid and Low-Cost Tool for Evaluation of Dysphagia: A Gold-Standard Comparison Study
title_fullStr The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) Is a Valid and Low-Cost Tool for Evaluation of Dysphagia: A Gold-Standard Comparison Study
title_full_unstemmed The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) Is a Valid and Low-Cost Tool for Evaluation of Dysphagia: A Gold-Standard Comparison Study
title_short The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) Is a Valid and Low-Cost Tool for Evaluation of Dysphagia: A Gold-Standard Comparison Study
title_sort swallowing clinical assessment score in parkinson s disease scas pd is a valid and low cost tool for evaluation of dysphagia a gold standard comparison study
url http://dx.doi.org/10.1155/2019/7984635
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