title: What is a clinically relevant difference in MDADI scores between groups of head and neck cancer patients?
abstract: To describe clinically relevant between-group differences in MD Anderson Dysphagia Inventory (MDADI) scores among head and neck cancer (HNC) patients.
  
  
  
  Retrospective cross-sectional study was conducted in 1,136 HNC patients seen for modified barium swallow (MBS) studies.
  
  
  
  The MDADI was administered by written questionnaire at the MBS appointment. MD Anderson Dysphagia Inventory global, composite, and subscale scores were calculated. Anchor-based methods were employed to determine clinically meaningful between-group differences by feeding tube status, aspiration status (per MBS study), and diet level.
  
  
  
  Mean MDADI scores for the 1,136 patients were: emotional 65.8 ± 17.3, functional 68.1 ± 19.6, physical 60.1 ± 18.6, global 59.3 ± 28.3, and composite 64.0 ± 17.1. Three hundred seventy-eight patients (33%) were feeding tube-dependent; 395 (34.8%) were aspirators; 122 (11%) were nothing per oral (Performance Status Scale-Head and Neck [PSS-HN] diet = 0); and 249 (22%) ate unrestricted, regular diets (PSS-HN diet = 100). Statistically significant (P < 0.0001) between-group differences (feeding tube vs. no feeding tube, aspirator vs. nonaspirator, oral vs. nonoral diet, PSS-HN diet levels) were observed for all mean MDADI scores (global, composite, and subscales). A mean difference of 10 points in composite MDADI scores differentiated feeding tube-dependent from nontube-dependent patients, aspirators from nonaspirators, and distinct PSS-HN diet levels.
  
  
  
  We identify that a 10-point between-group difference in composite MDADI scores was associated with clinically meaningful between-group differences in swallowing function.
  
  
  
  4. Laryngoscope, 126:1108-1113, 2016.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Hutcheson
authors.affiliation: Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Martha P
authors.initials: MP
authors.lastname: Barrow
authors.affiliation: Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Asher
authors.initials: A
authors.lastname: Lisec
authors.affiliation: Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Denise A
authors.initials: DA
authors.lastname: Barringer
authors.affiliation: Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Kacie
authors.initials: K
authors.lastname: Gries
authors.affiliation: Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Jan S
authors.initials: JS
authors.lastname: Lewin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D007440:Intubation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D000071081:Minimal Clinically Important Difference; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Dysphagia; MD Anderson Dysphagia Inventory (MDADI); head and neck cancer