Reliability and Validity of BarnesJewish Hospital Stroke Dysphagia Screen Test in Turkish Stroke Patients with the Fiberoptic Endoscopic Method - Abstract
Background: Early identification of dysphagia reduces morbidity and mortality in acute stroke patients. During the acute phase of stroke, the Barnes-Jewish Hospital Stroke Dysphagia Screen (BJH-SDS) is commonly recommended for such cases. In this study, our aim was to perform validity and reliability of the Turkish version of BJH-SDS with a different method.
Methods: The scale was administered to 140 acute stroke patients within the first 24 hours of the event. The procedures were scored by two blind independent expert observers. Cronbach’s alpha and item-to-total correlations were used to assess internal consistency. Inter-rater reliability studies were also conducted. Endoscopic evaluations were performed within the first 24 hours following the application of the screening tests. The flexible fiberoptic endoscopic evaluation of swallow (FEES) method was used to describe the validity of measures.
Results: The mean age of 140 patients [58 (41.4 %) female, 82 (58.6 %) male] included in the study was 67.20 (SD 12.82) years. The internal consistency of the test was good with Chronbach’s ? values between 0.831 and 0.894, and there was a very good inter-rater agreement based on an intra-class correlation coefficient between 0.850 and 1.000. The item-to-total correlation for test items was between 0.493 and 0.712, exceeding the commonly accepted level of > 0.3. A significant positive association between total test scores of the raters and FEES levels (r: 0.733 p=0.001 and r=0.744, p=0.001). Based on the total scores, the sensitivity and specificity for detecting the presence of dysphagia were 78.6% and 80 to 82.8%, respectively.
Conclusion: Our results suggest that the Turkish version of BJH-SDS that performed by using FEES method is a valid and reliable instrument when determining dysphagia in acute stroke patients.