Validation of the Dutch Version of the M.D. Anderson Dysphagia Inventory for Neurogenic Patients

Abstract

Background/Aim: The aim of this study was to validate the Dutch-language version of the M.D. Anderson Dysphagia Inventory (MDADI) for patients with neurogenic oropharyngeal dysphagia (OD). Methods: One hundred and seventy-eight patients with neurogenic OD and 92 healthy control subjects completed the MDADI and the Dutch version of the Swallowing Quality-of-Life Questionnaire (SWAL-QOL-NL). Exclusion criteria were: suffering from a concurrent head-and-neck oncological disease, scoring below 23 on a Mini Mental State Examination, being older than 85 years, and being illiterate or blind. None of the patients was in a palliative state of disease. Floor and ceiling effects, known-groups validity, internal consistency, construct validity, and criterion validity were assessed. Results: The MDADI total score showed no floor or ceiling effects for the patient group. Known-groups validity was confirmed by group differences in score distributions between patients and healthy control subjects. The internal consistency showed Cronbach’s α-values ranging from 0.77 to 0.92. Correlations between the MDADI subscales and SWAL-QOL-NL domains were moderate to strong: 0.71, 0.70, and 0.62 (convergent construct validity). Correlations between the MDADI scores and the SWAL-QOL-NL domains general burden, food selection, eating duration, communication, mental health, social functioning, and frequency of symptoms were moderate to strong, ranging from 0.41 to 0.75. Weak correlations (<0.4) were found between the MDADI scores and the SWAL-QOL-NL domains eating desire, sleep, and fatigue. Conclusion: The results of this study show that the Dutch translation of the MDADI is a psychometrically validated and suitable dysphagia-specific quality-of-life questionnaire for patients with neurogenic OD.