Evaluation Of The Chinese Version Of The Swallowing Disturbances Questionnaire In Patients With Parkinson’s Disease

Objective:Introduce the Swallowing Disturbances Questionnaire and translate it into Chinese version(SDQ-C). And verify the sensitivity and specificity of the Chinese version. Try to provide it as the effective and reliable screening tool for the research of dysphagia in PD patients. Methods:1. Work out the Chinese version of SDQ. To insure the language credibility and the validity, we adopted the international translational methods that were: pre-translation, retroversion, expert discussions and preliminary experiment in PD patients. Then we got the final SDQ-C. 2. SDQ-C and data collection: Between January 1, 2015 and December 31, 2015, 60 consecutive inpatients were enrolled from the department of neurology, the First Hospital, Shanxi Medical University. We collected their basic information among qualified patients. And they also completed the SDQ-C and the videofluoroscopic swallowing(VFSS) test which was the standard method in detecting dysphagia after they were informed consent. 3. Scale Evaluation: Cronbach’s α coefficient which represented the internal consistency coefficient, was used to evaluate the scale reliability. Statistics was analyzed by non-parameter Mann-Whitney U test and independent sample T test. Evaluation index we chose was the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and the Yueden’s index. We drew the receiver operating characteristic curve and calculated the area under the curve and identified the best cut-off point for the SDQ-C. We utilized the Fisher exact method to compare the outcomes of the SDQ-C and VFSS. We analyzed the diagnostic value of the SDQ-C among different people in several aspects: age, Hoehn-Yahr stage, scale value, and gender. The test level was 0.05 and P<0.05 for statistical significance was used. Results:1. The study took a total of 66 questionnaire survey. After eliminating incomplete basic data in the SDQ-C and patients cannot fulfill the VFSS test, we incorporated 60 patients. 37 cases were male and 23 cases were female. 12 cases(20%) went through aspiration during the VFSS, and the gender ration was 3:1; 48 cases(80%) didn’t suffer from aspiration, and the gender ration was 7:5. 2. The Cronbach’s α coefficient was 0.84 for the SDQ-C. The ages, Hoehn-Yahr stages, scale value in aspiration group was much higher than that in non-aspiration group. Differences were statistical significant(P<0.05). And the gender difference between the two groups were not significant(P>0.05). 3. The average age of those 60 patients was 67.7±6.9. The average value of the SDQ-C was 8.8 ± 7.0. And the average Hoehn-Yahr stage was 2.7 ± 1.3. 4. The best cut-off point of the SDQ-C was 11.5/44.5 point. The sensitivity was 75.0%, the specificity was 84.5%, positive predictive value was 56%, negative predictive value was 85%, the area under the curve is 0.782, and the 95% confidence interval(CI) was 0.634-0.931. 5. Divided by the cut-off point, there were 16 patients(26.7%)with values which were higher than 11.5 points, and 44 patients(73.3%)with values which were lower than 11.5 points. Compared to the standard method——VFSS, SDQ-C significantly predicted the existence of aspiration(P<0.01). Conclusion:1.Through pre-translation, retroversion, expert discussions and preliminary experiment in the crowd four steps, the final SDQ-C was formulated. After the testing of validity and reliability, and the evaluation of diagnostic test, the SDQ-C can be used as a screening tool for the dysphagia in PD patients. 2. SDQ-C performed good in the evaluation of indexes. The low sensitivity and high specificity of SDQ-C compared to the original SDQ may be related with the election of the patients enrolled, which need to be discussed. 3. The value of SDQ-C helps to screen if there was dysphagia in PD patients. The higher value the patient got the higher possibility that he or she had dysphagia, especially those patients with values higher than 11.5 points, and they need to run the VFSS to clarify the diagnosis. 4. When compared aspiration group to non-aspiration group in VFSS, they had higher values in ages, Hoehn-Yahr stages, scale values, which points out that these indexes may be the risk factors of dysphagia. And we didn’t find significant difference in the index of gender.