Validation of the Italian Version of the Functional Oral Intake Scale (FOIS-It) Against Fiberoptic Endoscopic Evaluation of Swallowing and Nutritional Status.
Aurora Ninfa, Nicole Pizzorni, Angelo Eplite and 2 others
PMID 33591464WHAT IT FOUND
The Italian Functional Oral Intake Scale accurately reflects swallowing safety and nutritional status in adults with mixed dysphagia causes.
Lower intake scores correlate with aspiration and malnutrition, supporting its use for standardized clinical documentation.
Key findings
01FOIS-It scores showed a moderate inverse correlation with the Penetration-Aspiration Scale, indicating that lower functional oral intake is associated with worse swallowing safety.
02Patients with malnutrition (BMI ≤ 18.5) had significantly lower FOIS-It median scores compared to those with normal nutritional status.
03FOIS-It scores were significantly lower in patients with penetration or aspiration across liquids and semisolids compared to those with safe swallowing.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was heavily weighted toward neurodegenerative diseases, with few patients having acute conditions like stroke. Some patients could not be tested with all food consistencies due to safety concerns, leading to missing data for solids in 52 patients. Malnutrition was diagnosed using BMI alone, without composite nutritional screening tools or blood biomarkers. The study did not assess test-retest reliability of the FOIS-It. Swallowing was assessed in a clinical setting, which may not reflect performance during a natural meal.
Declared interests
Funded by Università degli Studi di Milano. No commercial conflicts of interest were declared.
The easy way to misread this
Do not assume the FOIS-It strongly predicts pharyngeal residue. The correlation with swallowing efficiency was weak, and the scale is primarily supported as a measure of safety and nutritional status.