Validity of a dysphagia screening test following resection for head and neck cancer

A Correction to this article was published on 25 September 2020

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Abstract

Background

The aim of this study was to evaluate the validity of a dysphagia screening test (DST) in patients who have undergone resection for head and neck cancer (HNC). In addition, we examined whether or not combined effects of DSTs improve the detection accuracy of penetration/aspiration.

Methods

Thirty-six HNC patients were participated. The DST consisted of the repetitive saliva swallowing test (RSST), the water swallowing test (WST), the modified water swallowing test (MWST), the food test (FT), and tongue pressure. A videofluoroscopic swallowing study was conducted, and the penetration–aspiration scale was used for scoring. For statistical analyses, we used the receiver operating characteristic (ROC) analysis. Furthermore, the accuracy of the determination of penetration/aspiration was evaluated by combining two or three DSTs.

Results

The penetration/aspiration could be predicted with moderate accuracy based on MWST and FT. The area under the ROC curve (AUC) values of the MWST and FT were 0.76 (p = 0.03) and 0.80 (p = 0.050), and the sensitivity/specificity was 0.9/0.61 (MWST) and 0.8/0.8 (FT), respectively. As a result of combining 2 or 3 DSTs, the combination of “MWST and FT” was the most accurate, with an AUC of 0.87 (p = 0.02). The combination of three tests had lower accuracy than the combination of two tests.

Conclusion

Based on our results, it is recommended that MWST or FT be used when only one type of DST is performed. In addition, the combination of two DSTs may detect aspiration patients more accurately than one alone.

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Change history

  • 25 September 2020

    The above article was published online with error in Table 5 and 6.

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Acknowledgements

The authors would like to express their sincere appreciation to Ms. M. Shiramizu for her tremendous support. We also thank the doctors of the Department of Otorhinolaryngology–Head and Neck Surgery for their generous support.

Availability of data and material

The datasets during and/or analyzed during the current study available from the corresponding author on reasonable request.

Funding

This study was supported, in part, by the Ministry of Education, Culture, Sports, Science and Technology (MEXT) Supported Program for the Strategic Research Foundation at Private Universities, 2014–2018.

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Correspondence to Yoko Hasegawa.

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All procedures performed in studies involving human participants were conducted in accordance with the ethical standards of the institutional ethics committee at Hyogo College of Medicine (H28–1713) and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Consent to participate was obtained from all individual participants included in the study.

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The original version of this article was revised: "The above article was published online with error in Table 5 and 6. Some of the entries were mistakenly deleted under AUC column.

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Horii, N., Hasegawa, Y., Sakuramoto-Sadakane, A. et al. Validity of a dysphagia screening test following resection for head and neck cancer. Ir J Med Sci 190, 67–77 (2021). https://doi.org/10.1007/s11845-020-02286-4

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Keywords

  • Deglutition
  • Dysphagia
  • Head and neck cancer
  • Screening test
  • Videofluoroscopic swallowing study