Psychometric Properties of Outcome Measures
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Psychometric Properties of Outcome Measures: Isometric Force Output
Reliability
Study 1 Title: Diagnostic value of “dysphagia limit” for neurogenic dysphagia: 17 years of experience in 1278 adults.
The objective of this study was to investigate the dysphagia limit (DL) within a multitude of people and to perform a longitudinal assessment within subsets in the group for dysphagia. A quantitative approach was used to perform an objective assessment of the subjects. DL in this case refers to the second or subsequent swallows that may be necessary to swallow the whole amount of bolus.
The results of this study revealed a 91% sensitivity, a 91% specificity, and a 94% positive predictive value. The study had an 88% negative predictive value and an accuracy of 0.92. The confidence intervals for the high sensitivity group was 85-97%, and 90-99% for the positive predictive value (Aydogdu et al., 2015).
The type of reliability in this study is an inter-rater. Different groups were used to test for the dysphagia limit.
Study 2 Title: Orophangeal Dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study
The objective of this study was to examine the role played by Orophangeal Dysphagia (OD) as a contributing factor toward malnutrition and/or lower respiratory tract infections among independently living older people over 70 years.
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The study was a population-based study. In the study, 254 people were recruited for the study and 227 (accounting for 90%) of them were re-evaluated a year later (Serra-Prat et al., 2012).
The type of reliability in this study was a test-retest reliability whereby the same measure was conducted twice to the same group of people in two different times and the results compared to one another.
In the follow-up test, it was revealed that the incidence level was higher in subjects that had basal signs of impaired efficacy of swallow when compared to the subjects without such signs (40.0 % to 21.8%; P=0.030; OR=2.39).
Validity
Study 1 Title: Development and field testing of a novel patient-reported outcome measure of dysphagia in patients with eosinophilic esophagitis.
The objective of this study was to test a patient reported the outcome (PRO) for dysphagia among subjects for the study that had eosinophilic esophagitis. The study took a multi-phase prospective study approach. The second phase was conducted for 30 days and meant to test a questionnaire that was developed in the first phase. The second phase aimed at assessing the content validity of the questionnaire developed during the first phase (Dellon et al., 2013).
The confidence interval for the median number of 2 adolescents VS 4 adults was (P<0.001). The three-question patient reported outcome was successfully tested in this case study. The study has both face and content validity and can be used in clinical trials.
Study 2 Title: Identification of dysphagia using the Toronto Bedside Swallowing Screening Test (TOR-BSST) Are ten teaspoons of water necessary?
The test aimed at determining whether the ten teaspoons of water that are often used in the screening process of dysphagia are necessary. The study also sought to determine whether with each additional spoon the reliability of the accuracy of the identification process was identified (Martino, Maki & Diamant, 2014).
The results correctly identified that the ten teaspoons of water were necessary. Five teaspoons showed an accuracy of 79% (CI= 70-86), eight teaspoons showed an accuracy of 92% (CI= 85-96) while the ten teaspoons showed an accuracy of 96% (CI= 90-99). The type of validity, in this case, is a face validity with the actual study assessing the right constructs.
Responsiveness
Study 1 Title: Usefulness of the volume-viscosity swallow test for screening dysphagia in subacute stroke patients in rehabilitation income
The objective of the study was to evaluate the clinical screening capacity of the V-VST (Volume Viscosity Swallow Test) for orophangeal dysphagia. The study was a cohort study with 52 subacute phase stroke subjects. The study tests determined that the V-VST is a highly sensitive and specific test meant to detect aspiration. Its sensitivity level is 88.2%. It has a specificity of 71.4%, while the negative predictive value was 92.6%
According to the conclusions of the study, the test proved to be a low-cost method, that was also very responsive to changes in variables (such as coughing and aspiration) during the test process (Guillén-Solà et al., 2013).
Study 2 Title: Orophangeal Dysphagia is a risk factor for re-admission for pneumonia in the very elderly persons: Observational prospective study
The aim of the study was to determine whether the Orophangeal Dysphagia is a risk factor in the pneumonia disease and whether it contributed to re-admission for the pneumonia patients. The data collection in the study focused on a clinical database and electronic clinical notes.
In the study, the incidence rate of hospital re-admissions for pneumonia was 3.67 re-admissions for patients without Dysphagia in every 100 patients (95% CI 3.0 – 4.4). The incidence rate was 6.7 people for every 100 patients for those with Dysphagia. The subjects were followed for 24 months (Cabré et al., 2013). The measuring process in this case study is responsive to changes over the 24-month period.
References
Aydogdu, I., Kiylioglu, N., Tarlaci, S., Tanriverdi, Z., Alpaydin, S., Acarer, A., … & Ertekin, C. (2015). Diagnostic value of “dysphagia limit” for neurogenic dysphagia: 17years of experience in 1278 adults. Clinical Neurophysiology,126(3), 634-643.
Cabré, M., Serra-Prat, M., Force, L., Almirall, J., Palomera, E., & Clavé, P. (2013). Oropharyngeal dysphagia is a risk factor for readmission for pneumonia in the very elderly persons: observational prospective study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, glt099.
Dellon, E. S., Irani, A. M., Hill, M. R., & Hirano, I. (2013). Development and field testing of a novel patient‐reported outcome measure of dysphagia in patients with eosinophilic esophagitis. Alimentary pharmacology & therapeutics, 38(6), 634-642.
Guillén-Solà, A., Marco, E., Martínez-Orfila, J., Donaire Mejías, M. F., Depolo Passalacqua, M., Duarte, E., & Escalada, F. (2013). Usefulness of the volume-viscosity swallow test for screening dysphagia in subacute stroke patients in rehabilitation income. NeuroRehabilitation, 33(4), 631.
Martino, R., Maki, E., & Diamant, N. (2014). Identification of dysphagia using the Toronto Bedside Swallowing Screening Test (TOR-BSST©): Are 10 teaspoons of water necessary?. International journal of speech-language pathology, 16(3), 193-198.
Serra-Prat, M., Palomera, M., Gomez, C., Sar-Shalom, D., Saiz, A., Montoya, J. G., … & Clavé, P. (2012). Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study. Age and ageing, 41(3), 376-381.
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