title: Identification of a simple screening tool for dysphagia in patients with stroke using factor analysis of multiple dysphagia variables.
abstract: OBJECTIVE
  To identify a most useful and simple clinical screening tool to predict videofluoroscopic aspiration in patients with stroke.
  
  
  METHODS
  Factor analysis of multiple dysphagia variables and sensitivity and specificity testing with chi-square test.
  
  
  METHODS
  Sixty-one consecutive stroke patients with symptoms suggestive of dysphagia admitted to a university hospital and its 4 affiliated hospitals in Japan.
  
  
  METHODS
  Factors were extracted from 6 oromotor examinations (lip closure, tongue movement, palatal elevation, gag reflex, voice quality and motor speech function), 2 swallow screen tests (saliva swallowing test and our modified water swallowing test using 30 ml of water) and 4 parameters evaluated with a videofluoroscopic swallow study. Sensitivity and specificity of each dysphagia-related variable was determined against aspiration in a videofluoroscopic swallow study.
  
  
  RESULTS
  Factor analysis revealed that cough/voice change in the water swallowing test and aspiration on videofluoroscopic swallow study belonged to the same factor. Chi-square analysis showed that cough/voice change in the water swallowing test was the only variable that was significantly associated with aspiration on videofluoroscopic swallow study, with a sensitivity of 72% (95% CI: 61-83%) and a specificity of 67% (CI: 55-79%) as a predictor of aspiration (p<0.05).
  
  
  CONCLUSIONS
  We recommend our modified 30 ml water-swallowing test as a useful single task-screening tool to detect aspiration.
authors: Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan. kaori@reha.med.keio.ac.jp
authors: Kaori
authors: K
authors: Nishiwaki
authors: Tetsuya
authors: T
authors: Tsuji
authors: Meigen
authors: M
authors: Liu
authors: Kimitaka
authors: K
authors: Hase
authors: Naofumi
authors: N
authors: Tanaka
authors: Toshiyuki
authors: T
authors: Fujiwara
mesh_terms: D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D014741:Video Recording