Initial psychometric assessment of a functional oral. The dysphagia severity scale dss is a 7point comprehensive ordinal scale that combines treatment and diet table 1 7. Association between functionality assessment scales and. Bedside assessment protocol and grading scale for dysphagia in adults.
Kuhlemeier 2 4, sara palmer 2 4 1 gerodontology, department of gerodontology, division of gerontology and gerodontology, graduate school, tokyo medical and dental university 2 department of physical medicine and rehabilitation, johns hopkins. Screening tools are not used to measure dysphagia severity, or to guide dysphagia. Dysphagia outcome and severity scale doss is a scale. Eat10 questionnaire dysphagia assessment thickenup clear. The dysphagia outcome and severity scale doss is a simple, easytouse, 7point scale developed to systematically rate the functional severity of dyspha gia based on objective assessment and make recommen dations for diet level, independence level, and type of nutrition. Some people may be completely unable to swallow or may have trouble safely swallowing liquids, foods, or saliva. Dysphagia outcome and severity scale doss is a simple and easytouse point scale developed only to systematically evaluate the functional level of severity. Dysphagia symptom severity and quality of life full text. Examples of dysphagiaspecific standardized scales include the.
Doss abbreviation stands for dysphagia outcome and severity scale. The dysphagia in multiple sclerosis questionnaire dymus and the mann. It may be due to a structural or motility abnormality in the passage of solids or liquids from the oral cavity to the stomach. Another scale, the dysphagia outcome and severity scale, 12 reports interrater and intrarater reliability for 4 raters but no validity data or any information on sensitivity to change over time. There was a significant association between the scores of functional oral intake scale and dysphagia outcome and severity scale in poststroke patients which means when the swallowing is highly compromised, the level of intake by mouth will be smaller according to the evaluators analysis p. Introduction hand, it refers to a patients awareness of impaire swallowing is a complex function that affects the physical and mental health of all human beings. Severity was classified using the clinical descriptors of dysphagia severity from the dysphagia outcome and severity scale doss, 24 a validated swallow severity rating scale. This would provide the clinician with information regarding nutrition, weight loss, dentures, cognitive changes, recurrent pneumonia, among other things. For inclusion, participants had to be deemed suitable for assessment by their treating medical officer and capable of remaining in a semiupright. Physiology, assessment, and management pamela dodrill a memorie m. In japan, however, the prototype of the food intake level scale fils, a 10point observerrating scale to measure the severity of dysphagia, has been widely used since 1993 without any formal reliability and validity testing. The aim of this study was to examine the reliability and validity of a tool to measure the severity of dysphagia.
The dysphagia outcome and severity scale gists on observation of swallow deficits on videofluoro doss is a simple, easytouse, 7point scale developed. Results revealed that stroke patients had significantly. Clinical characteristics and dysphagia data were analyzed. This proposed scale shows promise for rating global dysphagia severity.
The dysphagia outcome and severity scale springerlink. What is shorthand of dysphagia outcome severity scale. This study also aimed to determine the utility of the constructed assessment and. What is the abbreviation for dysphagia outcome and severity scale.
The dysphagia outcome and severity scale doss is a simple, easytouse. Patients complaints range from the inability to initiate a swallow to the sensation of solids or. A simple, broadly applicable, standardized dysphagia severity scale would be useful to standardize dysphagia evaluations, to monitor recovery and efficacy of treatment and to study the consequences of dysphagia. Offers phagia a line of puree foods which helps ease the difficulty of preparing, storing and serving puree foods. Aspiration getting food or liquid into the airway pneumonia infection in the lungs malnutrition dehydration discomfort what causes dysphagia. Dysphagia is not a specific disease entity but is a symptom of other conditions and may be lifethreatening. Nair road, mumbai central, mumbai, maharashtra, india. Bedside assessment protocol and grading scale for dysphagia. Product information and order information provided on the web site. You can also look at abbreviations and acronyms with word doss in term. There is also order information about thickeners for foods and liquids. Dysphagia, defined as a dysfunction in the process of eating, 1 is one of the most prevalent and distressing symptoms among palliative care patients. Full text pdf 4564k abstracts references23 citedby4 a simple, broadly applicable, standardized dysphagia severity scale would be useful to standardize dysphagia evaluations, to monitor recovery and efficacy of treatment and to study the consequences of dysphagia. Reliability and validity of a tool to measure the severity of.
Aug 18, 2011 specifically, as part of previous research phd dissertation by rm, the pi a new measure of medical outcomes of dysphagia was developed, titled the medical outcomes of dysphagia mod scale. The dysphagia outcome and severity scale semantic scholar. The masa is also available in a version for patients with cancer called the masac. The dysphagia outcome and severity scale doss is widely used to measure dysphagia severity based on videofluoroscopy vfss. Methods the mdq is a 27item instrument comprised of 25 items from previously validated mayo clinic instruments,4,8,9,11 plus one item from the marks et al. What are some of the problems that may be linked to dysphagia. Textbook of rehabilitation for swallowing disorders associated with stroke, 1st ed. Only one study used pa scale scores to evaluate airway invasion in a group of stroke patients compared with a group of healthy controls. It also determined the effect of clinical experience, vfss audiorecording and training on doss irr.
Testing of a new scale measuring medical outcomes of. Related nice guidance for transcutaneous neuromuscular electrical. Doss dysphagia outcome and severity scale acronymattic. We developed a global dysphagia severity scale dss from.
The degree of dysphagia was assessed with dysphagia outcome and severity scale doss. This study proposes a standardized swallowing clinical assessment score scas in pd. A preliminary study neelam dilip babani, gayatri atmaram hattiangadi department of audiology and speech therapy, topiwala national medical college and bai yamunabai laxman nair ch. Sip size, masa, fois iopi, and pro measures use of scale in clinical assessment are unregulated sips similar to those from vfss. However, it is still unclear if dysphagia severity can be accurately assessed without using vf or ve. Dysphagia is an alarm symptom that warrants prompt evaluation to define the exact cause and initiate appropriate therapy. The present study aimed to construct a bedside assessment protocol and grading scale to assess and grade orophayngeal dysphagia in a heterogeneous sample of the patients. Aspiration pa scale is an ordinal scale that evaluates depth, response, and clearance of airway invasion to determine severity table 1 12. Assessment of behavioral factors, including but not limited to a acceptance of pacifier. Advancing practice pitts iccd 2014 5 clinical measures. To date, a variety of assessment tools have been developed to measure the severity of dysphagia. The dysphagia outcome and severity scale doss is a simple, easytouse, 7point scale developed to systematically rate the functional severity of dysphagia based on objective assessment and make recommendations for diet level, independence level, and type of nutrition.
Functional assessment of swallowing ability, including but not limited to typical developmental skills and task componentssuckling and sucking in infants, mastication in older children, oral containment, and manipulation and transfer of the bolus. This is a small list of some of the outcome measures available to us. Full text dysphagia in multiple sclerosis patients. Ab a simple, broadly applicable, standardized dysphagia severity scale would be useful to standardize dysphagia evaluations, to monitor recovery and efficacy of treatment and to study the consequences of dysphagia. Fortysix patients 64 % presented spillage, 20 28 % piecemeal deglutition, 26 36 % penetration, and 30 44 % retention. Outcome tracking tools in dysphagia management ciao seminars. Impact of dysphagia severity on clinical decision making via. Dss is clinically useful because vf or ve is not always required to determine the severity of dysphagia. Reliability and validity of a tool to measure the severity. The findings of dysphagia in patients with parkinsons disease. Rather than a single condition, the term dysphagia refers to a pathological state and its symptoms, and its diagnosis is considered in the following two stages.
Below are examples of some of the types of problems that may be linked to dysphagia. A performance status scale for head and neck cancer patients. The dysphagia related quality of life and perceived dysphagia symptom severity by patients will be used as a complementary information on oropharyngeal dysphagia. We aimed to validate an easytouse videofluoroscopic analysis tool, the bolus residue scale brs, for detection and classification of pharyngeal retention in the valleculae, piriform sinuses, andor the posterior pharyngeal wall. Accuracy of dysphagia severity scale rating without using. Psychometric assessment and validation of the dysphagia. This study investigated interrater reliability irr of the doss. Dysphagia can result from a wide variety of medical conditions, including acute or progressive neurological conditions, trauma, disease, or as a result of surgery andor medical treatments. Association between functionality assessment scales and the. The doss uses a scale of 7 normal in all situations to 1 severe. The penetrationaspiration scale pas, pooling score ps, and dysphagia outcome and severity scale doss were used for quantitative analysis. Pdf a swallowing clinical assessment score scas to evaluate.
Table 4 from the dysphagia outcome and severity scale. We developed a global dysphagia severity scale dss from videofluorographic swallowing studies which included subjective clinical ratings of functional swallowing. People with dysphagia have dificulty swallowing and may even experience pain while swallowing odynophagia. Initial psychometric assessment of a functional oral intake. Pdf accuracy of dysphagia severity scale rating without. Most swallowing problems can be managed, although the treatment you receive will depend on the type of dysphagia you have. A quantitative prospective research design was used. Doss dysphagia outcome severity scale in medical by. Gosa b a feeding and swallowing program, department of otolaryngology, boston childrens hospital, boston, mass. Definitions dysphagia dysphagia is defined as any difficulty or abnormality of swallowing. Not only does eating provide nutrients, but it also serves as important role in social interaction.
Gallo, journal dysphagia, year1999, volume14, pages9145. Interrater reliability of the dysphagia outcome and. Patients were also excluded if they had no dysphagia as evaluated by speech therapy utilizing the hartford hospital dysphagia rating scale see additional file 1 which was based on the dysphagia outcome and severity scale, or if there was preexisting dysphagia noted by speech therapy due to other comorbid conditions that are known to affect. Outcome tracking tools are commonly used in dysphagia research as a means of objectively measuring. You want to look for measures that are both valid and reliable. Impact of dysphagia severity on clinical decision making. Dysphagia is one of the most prevalent and distressing symptoms among palliative care patients, and a practical assessment tool is required. Thus, the aim of the study is to investigate the relationship between dysphagia symptom severity and quality of life of the patients with neurogenic dysphagia.
Evaluation of a clinical service model for dysphagia. Thus, the aim of the study is to investigate the relationship between dysphagia symptom severity. Has the participant learned to take small sips independently per recs. Dysphagia outcome and severity scalefinal revision full peroral. Oct 19, 2017 the dysphagia outcome and severity scale doss is widely used to measure dysphagia severity based on videofluoroscopy vfss.
Thus, normative data was collected for the same in 30 typical adults in the age range of 1870 years. Post stroke dysphagia psd is common and associated with poor outcome. The dysphagia outcome and severity scale doss is a simple, easytouse, 7point scale developed to systematically rate the functional severity of dysphagia based on objective assessment and make. Normal in all situations normal diet no strategies or extra time needed level 6. International dysphagia diet standardisation initiative iddsi. Apr 01, 2014 dysphagia status was determined from a cse conducted by their current treating clinician independent to the study within 24 h prior to the online assessment.
Dysphagia status was determined from a cse conducted by their current treating clinician independent to the study within 24 h prior to the online assessment. Learning outcomes yunderstand the relevance of dysphagia on oral health yoverview the evidencebase relating to dysphagia and oral care yoverview oral care products and evidencebased oral care protocols for patients with dysphagia ydemonstrate dental management of patients with. This gives a numeric score up to 200 and provides a rating scale mild, moderate severe for both dysphagia and aspiration. The dysphagia severity rating scale dsrs, which grades how severe dysphagia is based on fluid and diet modification and. We aimed to validate an easytouse videofluoroscopic analysis tool, the bolus residue scale brs, for detection and classification of pharyngeal retention in the valleculae, piriform sinuses, and or the posterior pharyngeal wall. From the findings of that cse, dysphagia severity was classified using the 7level dysphagia outcome and severity scale nondysphagic. The dysphagia outcome and severity scale disfagia brasil. The dysphagia outcome and severity scale doss is a simple, easytouse, 7point scale developed. Pdf the dysphagia outcome and severity scale mary purdy. This scale also requires that a videofluoroscopic swallowing study be completed for scoring purposes. Effectivenessofchintuckmaneuvertofacilitate swallowing in. Methods the inter and intrarater reliability was evaluated by three clinicians in 30 patients using weighted kappa statistics. The most common shorthand of dysphagia outcome severity scale is doss.
There are many reasons the muscles in the mouth or throat may not work properly for swallowing. Treatment will depend on whether your swallowing problem is in the mouth or throat oropharyngeal dysphagia, or in the oesophagus oesophageal dysphagia. A evaluation and treatment of swallowing disorders. Specifically, as part of previous research phd dissertation by rm, the pi a new measure of medical outcomes of dysphagia was developed, titled the medical outcomes of dysphagia mod scale. Intra and interjudge reliabilities of the doss was established by four clinicians on 5 consecutive patients who. Interrater reliability of the dysphagia outcome and severity. The following dysphagia scoring system, first utilised by mellow and pinkas knyrim et al. The mod consists of 3 subscales that each measure lung, nutritionhydration or psychological consequences in patients with swallowing difficulties.
There was a significant association between the scores of functional oral intake scale and dysphagia outcome and severity scale in poststroke patients which means when the swallowing is highly compromised, the level of intake by mouth will be smaller according to the evaluators analysis p mar 05, 2014 this gives a numeric score up to 200 and provides a rating scale mild, moderate severe for both dysphagia and aspiration. Development of international terminology and definitions for. This did not include swallow duration for thick liquids. None of the methods are a perfect match to the ndd.