How Valid and Reliable Is the International Dysphagia Diet Standardisation Initiative (IDDSI) When Translated into Another Language?
Sara Dahlström, Ida Henning, Jenny McGreevy and 1 others
PMID 35996035WHAT IT FOUND
The Swedish translation of the IDDSI framework was rated by experts as linguistically accurate and culturally applicable after revision.
Twenty speech-language pathologists showed very high agreement when recommending diet levels for ten fictitious patient cases using the translated terms.
Key findings
01After two rounds of expert review, all 11 IDDSI levels achieved high scores for linguistic correlation and for being understandable and applicable in a Swedish context.
02Twenty Swedish speech-language pathologists demonstrated very high inter-rater reliability (ICC > 0.9) when assigning IDDSI levels to ten fictitious patient cases.
03For one patient case involving silent aspiration and gastrostomy, 15 of 20 speech-language pathologists recommended IDDSI 2, which was considered incorrect compared to the original reference but reflected local practice.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The patient cases used for reliability testing were presented in English, which may have influenced the results despite participants being required to be proficient in English. Reliability was tested using an earlier version of the translation (version 4.0) before the final public review and revision. The study did not assess whether patients and their families could understand or prepare the recommended textures. The expert panel size decreased from 12 to 10 for the final review.
Declared interests
Funded by the Karolinska Institute. No other conflicts of interest are reported in the text.
The easy way to misread this
Do not assume that high inter-rater reliability means the Swedish IDDSI recommendations always align with international IDDSI references. In one case, 15 of 20 Swedish speech-language pathologists recommended a texture that was considered incorrect by the original IDDSI standard, suggesting that local clinical practices or interpretations may differ from the global framework.