Using Classical Test Theory to Determine the Psychometric Properties of the Deglutition Handicap Index

Speyer, Renée; Cordier, Reinie; Bouix, Clara; Gallois, Yohan; Woisard, Virginie

doi:10.1007/s00455-021-10250-2

Cited by 8 publications

(9 citation statements)

References 28 publications

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“…Items representing different dysphagia-related aspects of daily life and referring to either the psychosocial aspect of dysphagia, such as emotional, functional, or physical aspects, were related to each other. According to several [ 19 - 21 ] investigations, DHI is the most reliable tool for assessing the psychosocial impact of dysphagic patients, and it is most suitable for clinical purposes given the 25 items and the use of a uniform simple scoring format. The Cronbach’s alpha of the DHI total score supported the assumption that DHI is a unidimensional measure.…”

Section: Discussionmentioning

confidence: 99%

Short and Long-Term Voice and Swallowing-Related Quality of Life in Patients Who Underwent Total Laryngectomy and Tracheoesophageal Puncture

Marzouki¹,

Taylouni²,

Tonkal³

et al. 2022

Cureus

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Background Voice and swallowing disorders can create a profound psychosocial impact on the patient’s quality of life. The focus of this study is to assess the psychosocial disabling effects on patients after total laryngectomy (TLP) using pre-validated surveys called the Voice Handicap Index 10 (VHI) for voice disorders and the Dysphagia Handicap Index (DHI) for swallowing disorders. Methodology This is a retrospective cohort study that was done on a total of 21 patients. The study was conducted at King Abdulaziz University Hospital between 2017 and 2022. The Cronbach’s alpha value was used to evaluate internal consistency reliability. The relationship between DHI, VHI, and demographic and clinical variables was analyzed by correlation analysis. A p-value of <0.05 was considered statistically significant, and all the tests were two-sided. Results The Cronbach’s alpha coefficient satisfied the internal consistency reliability for VHI and DHI for both total and their subscale scores. For DHI, the total score and emotional subscale obtained an alpha of greater than 0.9, indicating excellent internal consistency, whereas both physical and functional alpha scores indicated good internal consistency (α = 0.888 and α = 0.863, respectively). For VHI, the total score and physical subscale of the VHI had excellent internal consistency (α = 0.957 and α = 0.937, respectively), while the functional and emotional subscales had good internal consistency (α = 0.865 and α = 0.894, respectively). The total DHI scores, as well as the functional subscale scores, were significant (p = 0.033, p = 0.025, respectively) in terms of self-reported dysphagia severity. A moderately severe group (69.00 ± 19.17) had higher mean total scores, whereas severe individuals had higher subscale mean scores according to self-reported dysphagia severity. Self-reported dysphagia severity was as follows: normal (n = 3, 14.3%), mild (n = 4, 19%), moderate (n = 8, 38.1%), and severe (n = 6, 28.6%). Conclusions The disability caused by voice and swallowing disorders can be evaluated by VHI and DHI which have been statistically validated as reliable tools to assess the effects of dysphagia and dysphonia on quality of life. Patients after laryngectomy have higher mean DHI and VHI overall and functional subscale scores. However, this study failed to establish any relationship between clinical and demographical characteristics of the patients with DHI and VHI index.

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Section: Discussionmentioning

confidence: 99%

Short and Long-Term Voice and Swallowing-Related Quality of Life in Patients Who Underwent Total Laryngectomy and Tracheoesophageal Puncture

Marzouki¹,

Taylouni²,

Tonkal³

et al. 2022

Cureus

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“…Swallowing disorders were characterized by:(a) clinical severity: (a) severe: massive primary and secondary inhalations, ineffective/absent cough, history or risk of pneumonia and presence of nutritional complications; (b) moderate: ineffective cough, possible inhalation, history or risk of pneumonia, moderate stasis, but no malnutrition; (c) mild: no primary and secondary inhalations, slight complications. Stasis of saliva or alimentary product has been classified as mild, moderate, and severe, in agreement with the physician's subjective judgment after product intake;(b) presence (yes/no) of choking/laryngeal penetration, corresponding to the visualization of food or liquids passing into the larynx;(c) presence (yes/no) of an airway protective mechanism (closure of the vocal cords, effective cough);(d) the presence (yes/no) of an oral transit defect, most often coinciding with retention of food in the mouth due to lack of initiation of swallowing;(e) presence (yes/no) of a pharyngeal transit defect resulting in the presence of food residue in the valleculae and/or the pyriform sinuses after the effort of swallowing; Collection of pulmonary events (pneumonia) since disease onset and current nutritional complications (including at least one of the three following conditions: malnutrition, defined as a body max index [BMI] < 21, changes in food consistency and need of nutritional supplement). The Deglutition Handicap Index (DHI) score, a self‐administered questionnaire on quality of life (QoL) related to swallowing problems 12 …”

Section: Methodsmentioning

confidence: 99%

UMSARS Versus Laryngoscopy‐Based Assessment of Dysphagia

Fassi

Traon

Mouchon

et al. 2023

Movement Disord Clin Pract

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Background Multiple System Atrophy (MSA) dysphagia is routinely assessed by the Unified Multiple System Atrophy Rating Scale (UMSARS) part I‐item 2. Objective To compare the UMSARS part I‐item 2 with an ear/nose/throat (ENT) expert physician assessment. Methods We retrospectively analyzed the data of MSA patients who underwent an ENT assessment (nasofibroscopic and radioscopic exam) and an annual UMSARS assessment. Deglutition Handicap Index (DHI) and pulmonary/nutrition complications were collected. Results Seventy‐five MSA patients were included. The ENT assessment revealed more severe dysphagia compared to the UMSARS part I‐item 2 score (P = 0.003). A higher proportion of patients with impaired protective mechanisms showed severe UMSARS‐based dysphagia (P = 0.005). Patients with choking and oral/pharyngeal transit defects and nutritional complications were equally distributed across UMSARS part I‐item 2 scores. Worse UMSARS part I‐item 2 scores had worse DHI scores. Conclusions The UMSARS‐based assessment of dysphagia does not capture key aspects of pharyngo‐laryngeal dysfunction reflecting swallowing efficiency.

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“…Internal consistency reliability is checked by calculating the Cronbach α coefficient based on the standardization terms for the entire questionnaire separately as well as for each subscale. A low Cronbach's alphas less than 0.70 indicates insufficient internal consistency, while a high Cronbach's alphas greater than 0.90 indicates project redundancy [28][29][30] . The structural validity is mainly reflected by the value of the KMO coefficient and the Bartlett sphericity test.…”

Section: Item Response Theory (Irt) Methods Can Contribute With Impor...mentioning

confidence: 99%

Development and testing of physical activity literacy scales for elementary school students

zan

et al. 2023

Preprint

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Background: At this stage, Chinese research on physical activity literacy is still in its infancy, and the domestic primary school students' physical activity literacy assessment questionnaire is also in a state of development. In this study, a set of questionnaire scales for measuring the physical activity literacy of primary school students was compiled according to the characteristics of primary school students in different school stages, and the population measurement was carried out by using this scale, and then the accuracy of the scale and the fit according to the Rasch model were judged. Methods: We compiled a set of scales for measuring the physical activity literacy of primary school students, and directly distributed the questionnaires to primary school students in four regions of Hebei Province, Sichuan Province, Shenzhen City and Qinghai Province for actual measurement. We also used Rasch analysis to study the single-dimensionality, reliability, resolution and fitting degree of the questionnaire to judge the accuracy of the scale, aiming to provide a strong reference for the subsequent revision and wide application of the questionnaire. Results: The item reliability coefficient of all questionnaires was 1, and the item separation degree was 16.08, 16.71 and 18.18, respectively, all of which were greater than 3, indicating that the internal consistency of the questionnaire was better and the students with different ability levels could be better distinguished. The one-dimensional hypothesis of the three questionnaires holds. The project-person figure shows that the difficulty of the questionnaire items can be well matched with the subject's ability level. The average values of Infit MNSQ and Outfit MNSQ in the questionnaire were between 0.5-1.5, and the overall fit was good, and the data were in good agreement with the ideal model. In the fitting statistics of a single entry, it was found that the three grade levels generally showed poor fitting on the questions of whether they should continue to exercise after injury, whether it was appropriate to be sedentary and inactive, whether weather with severe air pollution was suitable for outdoor sports, and motivation for sports tests and motivation to like challenges. In subsequent modifications, we will delete and improve these questions or modify the statements of these questions to appropriately increase the difficulty of the questions. Conclusion: The one-dimensional test passed, reliable and internally consistent of the questionnaire was high, the difficulty of the item and the matching degree of population ability were high, and the questionnaire fit the model well. The questionnaire as a whole can form a questionnaire on sports health literacy of primary school students with good reliability and validity.

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Using Classical Test Theory to Determine the Psychometric Properties of the Deglutition Handicap Index

Cited by 8 publications

References 28 publications

Short and Long-Term Voice and Swallowing-Related Quality of Life in Patients Who Underwent Total Laryngectomy and Tracheoesophageal Puncture

Short and Long-Term Voice and Swallowing-Related Quality of Life in Patients Who Underwent Total Laryngectomy and Tracheoesophageal Puncture

UMSARS Versus Laryngoscopy‐Based Assessment of Dysphagia

Development and testing of physical activity literacy scales for elementary school students

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