What Combination of Generic Bedside Screening Tools Is Optimal to Capture Patients with Penetration/Aspiration Due to Dysphagia? Comparing Single Bedside Tools Versus Combinations of Tools for Sensitivity and Specificity
<b>Background/Objectives</b>: This study aimed to explore the validity of various generic bedside screening tools, and combinations of these, for capturing dysphagia as compared to aspiration/penetration found through the Flexible Endoscopic Evaluation of Swallowing (FEES). <b>Meth...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-04-01
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| Series: | Geriatrics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2308-3417/10/3/63 |
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| Summary: | <b>Background/Objectives</b>: This study aimed to explore the validity of various generic bedside screening tools, and combinations of these, for capturing dysphagia as compared to aspiration/penetration found through the Flexible Endoscopic Evaluation of Swallowing (FEES). <b>Methods</b>: In this cross-sectional study, participants diagnosed with chronic pulmonary disease (<i>n</i> = 25), Parkinson’s disease (<i>n</i> = 26), multiple sclerosis (<i>n</i> = 24), or stroke (<i>n</i> = 25) participated. Patient-reported outcomes and clinical-rated assessments included: the four-question test (4QT), the Minimal Eating Observation Form—II, the Volume–Viscosity Swallow Test (V-VST), the Penetration–Aspiration Scale, and the FEES. Activities in daily living were assessed with the Barthel Index. The sensitivity, specificity, negative predictive value (NPV), positive predictive value, and accuracy were calculated. <b>Results</b>: The 100 participants’ median age was 72 years, and 42 were women. In total, 78 patients had eating difficulties (MEOF-II). According to the 4QT, 69 patients had dysphagia while 62 had it according to the V-VST. Furthermore, 29 patients had penetration/aspiration according to the FEES. All generic bedside tools performed better when combined with another tool, when compared to the identification of penetration/aspiration according to the FEES. The combination of the MEOF-II and 4QT as well as the combination of the MEOF-II and V-VST proved to have very high sensitivity (96.1–96.3%) and NPVs (92.3% in both instances). Combining the three tools, the MEOF-II, 4QT, and V-VST, did not improve the sensitivity or NPV. <b>Conclusions</b>: A combination of the MEOF-II and 4QT or the MEOF-II and V-VST bedside tools is recommended for identifying patients at risk of penetration/aspiration and in need of further in-depth clinical assessment. |
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| ISSN: | 2308-3417 |