PAD useful screening test for dysphagia in patients with stroke: Study

The study showed the emergence of the PAD test as a robust screening tool for post-stroke dysphagia. Researchers found significant inter- & intra-rater reliabilities (Kappa coefficient), high internal consistency, and strong correlations between PAD scores & videofluoroscopic swallowing study results. High specificity and sensitivity further solidified its status as a go-to screening tool.

As stroke remains a leading cause of disability worldwide, the validation of tools like the PADT represents a significant stride toward enhancing stroke care and rehabilitation efforts. By empowering healthcare providers with reliable and valid assessment tools, the research contributes to optimizing patient outcomes and reducing the burden of post-stroke complications.

Dysphagia, or difficulty swallowing, is a common complication following stroke, posing significant risks such as aspiration pneumonia and malnutrition. The PADT, a bedside screening tool designed to assess swallowing function, has gained traction in clinical practice due to its simplicity and efficiency. However, until now, its reliability and validity in the context of stroke patients have remained relatively unexplored.

Hyo Jong Kim, Chungbuk National University College of Medicine, Seowon-gu, Cheongju, Republic of Korea, and colleagues aimed to investigate the validity and reliability of the Practical Assessment of Dysphagia test as a quantitative and organ-specific test for stroke patients.

For this purpose, the researchers used PAD test data from 109 patients with stroke. Cronbach’s α value was used to analyze the internal consistency of the PAD. Based on the correlation between PAD and the videofluoroscopic swallowing study (VFSS), concurrent validity was evaluated. The diagnostic accuracy of the PAD test in stroke patients was measured using the area under the receiver operating characteristic (ROC) curve.

The key findings include:

• Intra- and inter-rater reliabilities (Intra-class Correlation Coefficient (ICC) = 0.98 and 0.99, respectively) were significant for the total PAD score.
• The functional dysphagia scale (FDS) score and penetration-aspiration score (PAS) correlated significantly with PAD.

The results of the ROC curve analysis with various cut-off points showed high sensitivity and specificity of the PAD test. The PAD has high validity and reliability. Therefore, it is a useful screening test for dysphagia in patients with stroke.

In conclusion, the study validates the Practical Assessment of Dysphagia Test as a reliable and valid tool for assessing swallowing difficulties in stroke patients. With its implications for clinical practice, the PADT stands poised to improve dysphagia management and enhance the quality of care for stroke survivors.

Reference:

Kim, H.T., Min, HJ. & Kim, H.J. Reliability and Validity Analyses of the Practical Assessment of Dysphagia Test in Stroke. Dysphagia (2024). https://doi.org/10.1007/s00455-024-10708-z