Validation of the German Version of Functional Oral Intake Scale (FOIS-G) for Flexible Endoscopic Evaluation of Swallowing (FEES).
Samra Hamzic, Tobias Braun, Martin Juenemann and 8 others
PMID 32342178WHAT IT FOUND
The German version of the Functional Oral Intake Scale showed high agreement between speech therapists and strong links to stroke disability and swallowing test scores.
It is a reliable tool for documenting what patients can safely eat and drink after a stroke.
Key findings
01Two experienced speech therapists agreed almost perfectly on the German scale scores during pretesting.
02Six raters showed high overall agreement and strong correlations when scoring the same patient recommendations.
03The scale scores correlated significantly with standard stroke outcome measures and endoscopic swallowing assessment results.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was retrospective, relying on existing hospital records rather than planned assessments. The scale was not tested for agreement with the 70 ml water swallow test directly, only correlated. Some patients could not perform the water swallow test due to severe symptoms, so that analysis used a smaller group of 76 patients. The Barthel Index correlation was weaker when data were simplified into broad categories, which differed from the original English scale's results.
The easy way to misread this
Do not assume this scale measures swallowing safety directly. It documents what the patient is allowed to eat based on clinical judgment and instrumental findings, but it does not replace the endoscopic exam itself.