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Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale

Steele, CM; Namasivayam-MacDonald, AM; Guida, BT; Cichero, JAY; Duivestein, J; Hanson, B; Lam, P; (2018) Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale. Archives of Physical Medicine and Rehabilitation , 99 (5) pp. 934-944. 10.1016/j.apmr.2018.01.012. Green open access

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Abstract

OBJECTIVE: To assess consensual validity, inter-rater reliability and criterion validity of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale (IDDSI-FDS), a new functional outcome scale intended to capture the severity of oropharyngeal dysphagia, as represented by the degree of diet texture restriction recommended for the patient. DESIGN: Participants assigned IDDSI-FDS scores to 16 clinical cases. Consensual validity was measured against reference scores determined by an author reference panel. Inter-rater reliability was measured overall and across quartile subsets of the dataset. Criterion validity was evaluated versus Functional Oral Intake Scale (FOIS) scores assigned by survey respondents to the same case scenarios. Feedback was requested regarding ease and likelihood of use. SETTING: Web-based survey. PARTICIPANTS: 170 respondents from 29 countries. INTERVENTIONS: N/A MAIN OUTCOME MEASURES: Consensual validity (% agreement, Kendall's tau), criterion validity (Spearman rank correlation), inter-rater reliability (Kendall's concordance and intra-class coefficients). RESULTS: The IDDSI-FDS showed strong consensual validity, criterion validity and inter-rater reliability. Scenarios involving liquid-only diets, transition from non-oral feeding or trial diet advances in therapy showed the poorest consensus, indicating a need for clear instructions on how to score these situations. The IDDSI-FDS showed greater sensitivity than the FOIS to specific changes in diet. The majority (> 70%) of respondents indicated enthusiasm for implementing the IDDSI-FDS. CONCLUSIONS: This initial validation study suggests that the IDDSI-Functional Diet Scale has strong consensual and criterion validity and can be used reliably by clinicians to capture diet texture restriction and progression in people with dysphagia.

Type: Article
Title: Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.apmr.2018.01.012
Publisher version: http://doi.org/10.1016/j.apmr.2018.01.012
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License.
Keywords: deglutition, deglutition disorders, dysphagia, functional outcome scales, texture modification
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering
URI: http://discovery.ucl.ac.uk/id/eprint/10043881
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