Validation of DYsphagia in MUltiple Sclerosis questionnaire – Czech version of DYMUS

Authors: J. Kolčava 1,2;  N. Lasotová 2;  P. Štourač 1,2;  J. Bednařík 1,2;  E. Vlčková 1,2
Authors‘ workplace: Neuroglická klinika LF MU, Brno 1;  Neurologická klinika FN Brno 2
Published in: Cesk Slov Neurol N 2020; 83/116(3): 285-290
Category: Original Paper
doi: 10.14735/amcsnn2020285


Aim: Swallowing problems are a relatively common and severe symptom of multiple sclerosis (MS), but dysphagia is often neglected and probably underestimated in clinical practice. The cause may be due to lacking a valid screening tool for evaluation in Czech for the risk of dysphagia in MS patients. The aim of our study was to create and validate the Czech version of the DYsphagia in MUltiple Sclerosis (DYMUS) questionnaire. It is a simple anamnestic tool consisting of 10 questions, where scores of 2 or more represent a positive screening for risk of dysphagia.

Materials and methods: The Czech version of the DYMUS questionnaire was created by the forward-backward translation method and validated on 48 MS patients and 33 healthy volunteers. The questionnaire was administered repeatedly 3–5 days apart to evaluate repeatability and reproducibility. The risk of dysphagia was reviewed using a screening 100- ml Water Swallowing test.

Results: DYMUS scores in healthy controls were between 0 and 2 (median 0). In MS patients, the values were significantly higher (P < 0.001) and ranged from 0 to 10 (median 1). An abnormal DYMUS score correlating with dysphagia (≥ 2) was demonstrated in 16 patients (33%), but only in one healthy subject (3%) (P < 0.001). Data correlated with expert testing (r = 0.66; P = 0.01) and reviewed screening testing (r = 0.49; P = 0.01). The repeatability evaluated by the Spearman correlation was 0.94 (P < 0.001), and the Cronbach alpha value reflecting reproducibility reached 0.954 demonstrating high internal consistency of the questionnaire.

Conclusion: The Czech version of the DYMUS questionnaire showed very good validity, reproducibility and internal consistency of testing in the screening of dysphagia in MS patients.


multiple sclerosis – dysphagia – questionnaire – validation


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