Creation of a 13-Item Bedside Dysphagia Screening Test
Petra Mandysova, Vice-Dean, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic; Neurology Clinic, Pardubice Regional Hospital, Czech Republic,
Jana Škvrňáková, Vice-Dean, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic; Otorhinolaryngology and Head and Neck Surgery Clinic, Pardubice Regional Hospital, Czech Republic,
Edvard Ehler, Chief of Staff, Neurology Clinic, Pardubice Regional Hospital, Czech Republic; Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
Michal Černý, Otorhinolaryngology and Head and Neck Surgery Clinic, Pardubice Regional Hospital, Czech Republic; Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
Online J Health Allied Scs. 2010;9(4):6
Table 2: Results of FEES testing and physical examination items
|
FEES (PAS score) |
Spasms of neck and face |
Dysarthria | Whisper | Aphasia | Inability to clench teeth | Face weakness/ asymmetry | Abnormal status of the oral cavity | Tongue weakness / asymmetry | Abnormal tongue sensation | Abnormal soft palate sensation | Soft palate movement is not symmetri-cal, uvula deviation occurs | Gag reflex is absent | Voluntary cough is absent |
Inability to swallow saliva |
Voice change |
Inability to shrug shoulders / shoulder weakness |
Thickened fluids: unable to swallow without choking |
Thickened fluids: voice hoarse after swallowing |
Thickened fluids: cough after swallowing |
Thickened fluids: dripping from mouth |
Teaspoons of un-thickened fluids: voice hoarse after swallowing |
Teaspoons of un-thickened fluids: cough after swallowing |
Drinking un-thickened fluids: cough after swallowing |
Drinking un-thickened fluids: dripping from mouth | |
|
Patients with abnormal FEES results (17 patients) | |||||||||||||||||||||||||
| Frequency of abnormal result (absolute) | 17 | 3 | 10 | 1 | 1 | 2 | 13 | 2 | 7 | 4 | 1 | 2 | 6 | 1 | 4 | 15 | 8 | 2 | 3 | 6 | 2 | 2 | 3 | 2 | 2 |
| Frequency of abnormal result (%) | 100 | 17.6 | 58.8 | 5.9 | 5.9 | 11.8 | 76.5 | 11.8 | 41.2 | 23.5 | 5.9 | 11.8 | 35.3 | 5.9 | 23.5 | 88.2 | 47.1 | 11.8 | 17.6 | 35.3 | 11.8 | 11.8 | 17.6 | 11.8 | 11.8 |
|
Patients with normal FEES results (24 patients) | |||||||||||||||||||||||||
| Frequency of abnormal result (absolute) | 0 | 3 | 7 | 0 | 2 | 0 | 11 | 1 | 6 | 3 | 3 | 0 | 4 | 0 | 2 | 18 | 5 | 0 | 0 | 4 | 0 | 0 | 5 | 6 | 0 |
| Frequency of abnormal result (%) | 0.0 | 12.5 | 29.2 | 0.0 | 8.3 | 0.0 | 45.8 | 4.2 | 25.0 | 12.5 | 12.5 | 0.0 | 16.7 | 0.0 | 8.3 | 75.0 | 20.8 | 0.0 | 0.0 | 16.7 | 0.0 | 0.0 | 20.8 | 25.0 | 0.0 |
| PE items that are normal in normal-FEES patients and that are abnormal in > 10% of the abnormal-FEES patients (see text) | x | x | x | x | x | x | x | ||||||||||||||||||
| PE items that are abnormal in more than 50% of the abnormal-FEES patients (see text) | x | x | x | ||||||||||||||||||||||
| PE items that do not increase the test’s difficulty (see text) | x | x | x | ||||||||||||||||||||||
| Final dysphagia screening test items (see text) | x | x | x | x | x | x | x | x | x | x | x | x | x | ||||||||||||
| Legend: PE = physical examination | |||||||||||||||||||||||||
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