Validation of the Swedish Dynamic Imaging Grade of Swallowing Toxicity for Flexible Endoscopic Evaluation of Swallowing (DIGEST-FEES).
Kerstin Petersson, Caterina Finizia, Nina Pauli and 1 others
PMID 39331200WHAT IT FOUND
Swedish DIGEST-FEES ratings agreed with established swallowing measures and between two experienced speech-language pathologists.
It can be used to assess head and neck cancer swallowing after radiotherapy.
Key findings
01Ratings from the Swedish DIGEST-FEES varied from fair to substantial agreement with established instrumental and patient-reported swallowing measures.
02Two experienced speech-language pathologists who rated the recordings separately showed substantial agreement on safety and overall grade and almost perfect agreement on efficiency.
03The Swedish DIGEST-FEES overall grade correlated 0.80 with the Swallowing Performance Scale and 0.67 with the worst penetration-aspiration score.
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 test whether the Swedish DIGEST-FEES is sensitive to change or responsive to treatment, so it is not yet proven for tracking swallowing recovery. All participants had been treated with radiotherapy, and no surgically treated head and neck cancer patients were included, so the results may not apply to patients whose swallowing difficulty follows surgery. Content validity was not examined in this study, although the authors note it had been assessed in earlier DIGEST and FEES adaptation work. The agreement with patient-reported swallowing quality of life was only moderate, so the scale should not be used alone to represent how the patient feels about swallowing. The validation used 89 recordings from 47 participants, and 42 participants contributed two recordings, so the number of recordings is larger than the number of patients.
Declared interests
The study was funded by the University of Gothenburg. The supplied text does not include a conflict-of-interest declaration.
The easy way to misread this
Do not conclude that the Swedish DIGEST-FEES can be used to track treatment response in all head and neck cancer patients. The study did not test sensitivity or responsiveness, and it included only radiotherapy-treated patients.