Application of the GUSS test on adult Egyptian dysphagic patients

Abstract

BackgroundThe evaluation of swallowing disorders and their rehabilitative modalities is an important topic. The benefit to the patient, in terms of improvement in quality of life, cannot be underestimated. Bedside tests might be used to identify patients with oropharyngeal dysphagia and to identify those who are at a risk for aspiration.AimThe aim of the present study was to evaluate the validity and reliability of the Gugging Swallowing Screening (GUSS) test for the detection of aspiration and swallowing abnormalities in dysphagic Egyptian patients. This helps in better management.Study designThe present study was a comparative, cross-sectional study.Patients and methodsA total of 42 patients were referred from the outpatient clinics with a complaint of dysphagia. All patients were evaluated using flexible endoscopic examination of swallowing (FEES) and the GUSS test. The results of these two methods were compared to assess validity. Reliability was approved by the assessment of the Cohen’s κ agreement between the two independent raters.ResultsThe mean age of the patients was 51.6±12.2 years. According to the results of FEES, 28 (66.7%) patients were at a risk for aspiration, whereas 30 (71.4%) patients were rated to be at a risk according to the GUSS test results. According to the cutoff of 14 points, GUSS reached 93.3% sensitivity and 83.3% specificity when compared with FEES. Positive predictive value was 93.3% and negative predictive value was 83.3%. The results of reliability (by comparing the scores of the two raters as regards the degree of severity) showed excellent agreement between the two raters (κ=0.84, P>0.05, PO=91%).ConclusionGUSS test proved to be an easy, valid, and reliable test to predict the risk for aspiration among the adult Egyptian patients.