Validation of the Czech Version of the Dysphagia in Multiple Sclerosis Questionnaire (DYMUS).
Klára Novotná, Jiří Motýl, Lucie Friedová and 6 others
PMID 36289072WHAT IT FOUND
The Czech DYMUS questionnaire reliably screens for swallowing difficulties in multiple sclerosis patients.
Dropping the weight-loss item improved the scale, and electronic administration worked as well as paper. A score of 2 or more suggests dysphagia, though the sample had mostly mild disability.
Key findings
01The study authors propose removing item Q10 (weight loss) from the DYMUS questionnaire because it functioned poorly within the scale, resulting in a 9-item version.
02Electronic and paper versions of the questionnaire showed comparable item statistics and no significant differences in results based on the administration method.
03The study found a prevalence of dysphagia symptoms of approximately 11% in the multiple sclerosis sample, which is lower than other validation studies, likely due to the mild disability level of the participants.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study did not validate the questionnaire against objective instrumental tests like videofluoroscopy or endoscopy, so it relies on self-report which may miss silent aspiration. The sample was not random and overrepresented patients with mild disability (median EDSS 2.0), which may limit the generalizability of findings to more severe MS cases. Data collection was cut short due to COVID-19, potentially introducing selection bias, though the authors argue it was time-based. The study was conducted at a single center in the Czech Republic. Test-retest reliability was not assessed in the short term; stability was only measured after one year, which is a long interval for MS symptom fluctuation.
Declared interests
The study was funded by the Grant Agency of the Czech Republic and Charles University in Prague. No other conflicts of interest were declared.
The easy way to misread this
Do not assume this tool accurately detects all cases of dysphagia in MS. Because the study did not compare results to instrumental swallowing tests and the sample had mild disability, a low score does not rule out silent aspiration or swallowing problems in patients with more advanced disease.