Screening tools for dysphagia: a systematic review

Etges, Camila Lucia; Scheeren, Betina; Gomes, Erissandra; Barbosa, Lisiane De Rosa

doi:10.1590/2317-1782/20142014057

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Systematic Review • CoDAS 26 (5) • Sep-Oct 2014 • https://doi.org/10.1590/2317-1782/20142014057 linkcopy

Screening tools for dysphagia: a systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Purpose: To perform a systematic review of screening instruments for dysphagia available in the literature.

Methods: For the selection of studies, the following descriptors were used: "questionários", "questionnaires", "transtornos de deglutição", "deglutition disorders", "programas de rastreamento", and "mass screening". The online databases used for the research were Virtual Health Library (LILACS, IBECS, MEDLINE, Cochrane Library, SciELO) and PubMed. The research was performed from April to June 2013. Selection criteria articles in English, Portuguese, and Spanish, regardless of the year of publication, whose title, abstract, or text had any relation to the purpose of the research. After reading the articles in their entirety, identification data and method of the articles were extracted for later analysis.

Results: The research carried out from the proposed descriptors produced 1,012 articles. After reviewing the titles, summaries, and fully reading the articles, 20 studies were chosen. The publications on instruments for the identification of dysphagic patients started in 1999, and 50% of the analyzed studies were carried out in the USA. The methods used on the instruments were questionnaires, observation of patient's clinical signals and symptoms, the request for execution of some orofacial movements, and swallowing test with water or food.

Conclusion: Screening instruments in dysphagia are fairly heterogeneous and have been developed for different audiences with the main objective of identifying patients with swallowing disorders.

Speech, Language and Hearing; Sciences; Deglutition; Deglutition Disorders; Mass Screening; Questionnaires

Study	Authors	Year	Country	Instrument used	Instrument method
A screening procedure for oropharyngeal dysphagia	Logemann et al.(¹⁹)	1999	USA	Northwestern Dysphagia Patient Check Sheet	Questionnaire containing items related to clinical history, signs and symptoms, and clinical conditions; swallowing test with foods of different viscosities
Analysis of a physician tool for evaluating dysphagia on an inpatient stroke unit: the modified Mann Assessment of Swallowing Ability	Antonios et al.(²¹)	2010	USA	The Modified Mann Assessment of Swallowing (MMASA)	Observation of clinical signs and symptoms; request to perform orofacial movements
A feasibility study of the sensitivity of emergency physician dysphagia screening in acute stroke patients	Turner-Lawrence et al.(²²)	2009	USA	Emergency Physician Dysphagia Screen	Observation of clinical signs and symptoms; swallowing test with water
The DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis	Bergamaschi et al.(²³)	2008	Italia	Dysphagia in Multiple Sclerosis: DYMU	Questionnaire in which the patient responds "yes" or "no" for each item
Validity and Reliability of the Eating Assessment Tool (EAT-10)	Belafsky et al.(²⁴)	2008	USA	The Eating Assessment Tool (EAT-10)	Questionnaire in which the patient responds in a range of intensity for each item
Dysphagia in patients with Duchenne muscular dystrophy evaluated with a questionnaire and videofluorography	Hanayama et al.(²⁵)	2008	Japan	Questionnaire used to elicit symptoms related to swallowing	Questionnaire in which the patient responds in a range of intensity for each item
The 3-ounce (90-cc) water swallow challenge: a screening test for children with suspected oropharyngeal dysphagia	Suiter et al.(²⁶)	2009	USA	3-ounce (90-cc) water swallow test	Swallowing test with water
Patients' awareness of symptoms of dysphagia	Boczko(²⁷)	2006	USA	Symptoms of dysphagia	Questionnaire in which the patient responds "yes" or "no" for each item
The Massey Bedside Swallowing Screen	Massey and Jedlicka(²⁸)	2002	USA	Massey Bedside Swallowing Screen	Observation of clinical signs and symptoms.Request to perform orofacial movements; swallowing test with water
A novel emergency department dysphagia screen for patients presenting with acute stroke	Schrock et al.(²⁹)	2011	USA	MetroHealth Dysphagia Screen	Observation of clinical signs and symptoms
Bedside assessment of swallowing: a useful screening tool for dysphagia in an acute geriatric ward	Sitoh et al.(³⁰)	2000	UK	Bedside Swallowing Assessment Protocol	Swallowing test with water
Detecting dysphagia in inclusion body myositis	Cox et al.(³¹)	2009	Netherlands	Questionnaire	Questionnaire completed by the patient
Clinical utility of the 3-ounce water swallow test	Suiter and Leder(³²)	2008	USA	3-ounce water swallow test	Swallowing test with water
Validation of a Swallowing Disturbance Questionnaire for detecting dysphagia in patients with Parkinson's disease	Manor et al.(³³)	2007	Israel	Swallowing Disturbance Questionnaire	Questionnaire in which the patient responds in a range of intensity for each item and "yes" or "no" for the last question
Prevalence of dysphagia among community-dwelling elderly individuals as estimated using a questionnaire for dysphagia screening	Kawashima et al.(³⁴)	2004	Japan	Dysphagia Screening Questionnaire	Questionnaire in which the patient responds in a range of intensity for each item
Development and preliminary validation of a patient-reported outcome measure for swallowing after total laryngectomy (SOAL questionnaire)	Govender et al.(³⁵)	2012	UK	Swallow Outcomes After Laryngectomy (SOAL)	Questionnaire in which the patient responds in a range of intensity for each item
Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: a self-reporting questionnaire survey	Holland et al.(³⁶)	2011	UK	Sydney Swallow Questionnaire (SSQ)	Questionnaire in which the patient responds in a range of intensity for each item
Validation of the Sydney Swallow Questionnaire in a cohort of head and neck cancer patients	Dwivedi et al.(³⁷)	2010	UK	Sydney Swallow Questionnaire (SSQ)	Questionnaire in which the patient responds in a range of intensity for each item
Swallowing Disturbance Questionnaire for detecting dysphagia	Cohen and Manor(³⁸)	2011	Israel	Swallowing Disturbance Questionnaire (SDQ)	Questionnaire in which the patient responds in a range of intensity for each item and "yes" or "no" for the last question
Accuracy of a bedside dysphagia screening: a comparison of registered nurses and speech therapists	Weinhardt et al.(³⁹)	2008	USA	Dysphagia Screening Tool	Observation of clinical signs and symptoms; swallowing test with foods of different viscosities

Underlying pathologies	Articles
Cerebral vascular accident	Antonios et al.(²¹); Turner-Lawrence et al.(²²); Massey and Jedlicka(²⁸); Schrock et al.(²⁹); Weinhardt et al.(³⁹)
Multiple sclerosis	Bergamaschi et al.(²³)
Duchenne muscular dystrophy	Hanayama et al.(²⁵)
Inclusion body myositis	Cox et al.(³¹)
Head and neck cancer	Govender et al.(³⁵); Dwivedi et al.(³⁷)
Parkinson's disease	Manor et al.(³³)
Heterogeneous etiologies (neurological disorders, head and neck cancer, esophageal abnormalities, respiratory and heart problems, among others)	Logemann et al.(¹⁹); Belafsky et al.(²⁴); Suiter et al.(²⁶); Boczko(²⁷); Sitoh et al.(³⁰); Suiter and Leder(³²); Kawashima et al.(³⁴); Holland et al.(³⁶); Cohen and Manor(³⁸)

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