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

Overview

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.

Keywords:

multiple sclerosis – dysphagia – questionnaire – validation


Sources

1. Calcagno P, Ruoppolo G, Grasso MG et al. Dysphagia in multiple sclerosis – prevalence and prognostic factors. Acta Neurol Scand 2002; 105 (1): 40–43. doi: 10.1034/j.1600-0404.2002.10062.x.

2. Fernandes AM, Duprat Ade C, Eckley CA et al. Oropharyngeal dysphagia in patients with multiple sclerosis: do the disease classification scales reflect dysphagia severity. Braz J Otorhinolaryngol 2013; 79 (4): 460–465. doi: 10.5935/1808-8694.20130082.

3. Guan XL, Wang H, Huang HS et al. Prevalence of dysphagia in multiple sclerosis: a systematic review and meta-analysis. Neurol Sci 2015; 36 (5): 671–668. doi: 10.1007/s10072-015-2067-7.

4. Pajouh SD, Moradi N, Yazdi MJ et al. Dia­gnostic evaluation of dysphagia in multiple sclerosis patients using a Persian version of DYMUS questionnaire. Mult Scler Relat Disord 2017; 17: 240–243. doi: 10.1016/j.msard.2017.08.012.

5. Solaro C, Rezzani C, Trabucco E et al. Prevalence of patient-reported dysphagia in multiple sclerosis patients: an Italian multicenter study (using the DYMUS questionnaire). J Neurol Sci 2013; 331 (1–2): 94–97. doi: 10.1016/j.jns.2013.05.020.

6. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS). Neurology 1983; 33 (11): 1444–1452. doi: 10.1212/wnl.33.11.1444.

7. Thomas F, Wiles CM. Dysphagia and nutritional status in multiple sclerosis. J Neurol 1999; 246 (8): 677–682. doi: 10.1007/s004150050431.

8. Bergamaschi R, Crivelli P, Rezzani C et al. The DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. J Neurol Sci 2008; 269 (1–2): 49–53. doi: 10.1016/j.jns.2007.12.021.

9. Wiesner W, Wetzel SG, Kappos L et al. Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms. Eur Radiol 2002; 12 (4): 789–792. doi: 10.1007/s003300101086.

10. Tassorelli C, Bergamaschi R, Buscone S et al. Dysphagia in multiple sclerosis: from pathogenesis to dia­g­-nosis. Neurol Sci 2008; 29 (Suppl 4): S360–S363. doi: 10.1007/s10072-008-1044-9.

11. Sumelahti ML, Hakama M, Elovaara I et al. Causes of death among patients with multiple sclerosis. Mult Scler 2010; 16 (12): 1437–1442. doi: 10.1177/1352458510379244.

12. Belafsky P, Mouadeb D, Rees C et al. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol 2008; 117 (12): 919–924. doi: 10.1177/000348940811701210.

13. Ekberg O, Hamdy S, Woisard V et al. Social and psychological burden of dysphagia: its impact on dia­gnosis and treatment. Dysphagia 2002; 17 (2): 139–146. doi: 10.1007/s00455-001-0113-5.

14. Hemmett L, Holmes J, Barnes M et al. What drives quality of life in multiple sclerosis? QJM 2004; 97 (10): 671–676. doi: 10.1093/qjmed/hch105.

15. Prosiegel A, Schelling E, Wagner-Sonntag E. Dysphagia and multiple sclerosis. Int MS J 2004; 11 (1): 22–31.

16. Patel DA, Sharda R, Hovis KL et al. Patient-reported outcome measures in dysphagia: a systematic review of instrument development and validation. Dis Esophagus 2017; 30 (5): 1–23. doi: 10.1093/dote/dow028.

17. Bergamaschi R, Rezzani C, Minguzzi S et al. Validation of the DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. Funct Neurol 2009; 24 (3): 159–162.

18. Printza A, Kalaitzia M, Bakirtzisb C et al. Reliability and validity of the DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis (Greek version) and proposed modification. Mult Scler Relat Disord 2018; 23: 62–68. doi: 10.1016/j.msard.2018.05.004.

19. Sales D, Alvarenga R, Vasconcelos C et al. Translation, cross-cultural adaptation and validation of the Portuguese version of the DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. Springerplus 2013; 2: 332. doi: 10.1186/2193-1801-2-332.

20. Beaton DE, Bombardier C, Guillemin F et al. Guidelines for the process of cros s-cultural adaptation of self-report measures. Spine 2000; 25 (24): 3186–1391.

21. Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 1993; 46 (12): 1417–1432. doi: 10.1016/0895-4356 (93) 90142-n.

22. Thompson A, Banwell B, Barkoff F et al. Dia­gnosis of multiple sclerosis: 2017 revisions of the McDonald Criteria. Lancet Neurol 2018; 17 (2): 162–173. doi: 10.1016/S1474-4422 (17) 30470-2.

23. Wu MC, Chang YC, Wang TG et al. Evaluating swallowing dysfunction using a 100- ml water swallowing test. Dysphagia 2004; 19 (1): 43–47. doi: 10.1007/s00455-003-0030-x.

24. Bot AG, Becker SJ, Mol MF et al. Validation of phone administration of short-form disability and psychology questionnaires. J Hand Surg Am 2013; 38 (7): 1383–1387. doi: 10.1016/j.jhsa.2013.03.033.

25. Alali D, Ballard K, Bogaardt H. Treatment effects for dysphagia in adults with multiple sclerosis: a systematic review. Dysphagia 2016; 31 (5): 610–618. doi: 10.1007/s00455-016-9738-2.

26. Terre-Boliart R, Orient-Lopez D, Guevara-Espinosa S et al. Oropharyngeal dysphagia in patients with multiple sclerosis. Rev Neurol 2003; 39 (8): 707–710. doi: 10.33588/rn.3908.2004247.

27. Tenekeci E, Kara B, Cetiz A et al. Validity and reliability of the Turkish version of the questionnaire for the assessment of dysphagia in multiple sclerosis. Arch Neuropsychiatr 2016; 55 (3): 243–247. doi: 10.5152/npa.2016.18105.

28. Dušek L, Pavlík T, Koptíková J. Analýza dat v neurologii VI. Přesnost, spolehlivost a reprodukovatelnost měření u diskrétních dat. Cesk Slov Neurol N 2007; 70/103 (6): 719-721.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 3

2020 Issue 3

Most read in this issue

This topic is also in:


Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account