What is a clinically relevant difference in MDADI scores between groups of head and neck cancer patients?
What is a clinically relevant difference in MDADI scores between groups of head and neck cancer patients?
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DOI：
10.1002/lary.25778
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发表时间：
2016-05
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影响因子：
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通讯作者：
Lewin JS
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文献类型：
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作者：
Hutcheson KA;Barrow MP;Lisec A;Barringer DA;Gries K;Lewin JS
描述头颈癌（HNC）患者中MD安德森吞咽困难量表（MDADI）评分的临床相关组间差异。对1,136例接受改良吞钡（MBS）研究的HNC患者进行了回顾性横断面研究。在MBS预约时通过书面问卷进行MDADI。计算MDADI总体、复合和子量表评分。采用基于锚点的方法，通过饲管状态、抽吸状态（根据MBS研究）和饮食水平确定组间差异的临床意义。1，136例患者的平均MDADI评分为：情感65.8±17.3，功能68.1±19.6，身体60.1±18.6，总体59.3±28.3，综合64.0±17.1。378例患者（33%）依赖饲管，395例患者（34.8%）使用吸引器; 122例（11%）口服无任何食物（PSS-HN饮食=0），249例（22%）进食不受限制的常规饮食（PSS-HN饮食=100）。对于所有平均MDADI评分（总体、复合和子量表），观察到组间差异（饲管与无饲管、吸引器与非吸引器、口服与非口服饮食、PSS-HN饮食水平）具有统计学显著性（p<0.0001）。复合MDADI评分的平均差异为10分，区分了饲管依赖与非饲管依赖患者、抽吸器与非抽吸器以及不同的PSS-HN饮食水平。我们发现，复合MDADI评分的10分组间差异与吞咽功能的临床有意义的组间差异相关。
To describe clinically relevant between group differences in MD Anderson Dysphagia Inventory (MDADI) scores among head and neck cancer (HNC) patients. Retrospective cross-sectional study was conducted in 1,136 HNC patients seen for modified barium swallow (MBS) studies. The MDADI was administered by written questionnaire at the MBS appointment. MDADI global, composite, and subscale scores were calculated. Anchor-based methods were employed to determine clinically meaningful between group differences by feeding tube status, aspiration status (per MBS study), and diet level. Mean MDADI scores for the 1,136 patients were: emotional 65.8±17.3, functional 68.1±19.6, physical 60.1±18.6, global 59.3±28.3, and composite 64.0±17.1. Three hundred-seventy-eight patients (33%) were feeding tube dependent and 395 (34.8%) were aspirators; 122 (11%) were nothing per oral (PSS-HN diet=0) and 249 (22%) ate unrestricted, regular diets (PSS-HN diet=100). Statistically significant (p<0.0001) between group differences (feeding tube vs. no feeding tube, aspirator vs. non-aspirator, oral vs. non-oral diet, PSS-HN diet levels) were observed for all mean MDADI scores (global, composite, and subscales). A mean difference of 10 points in composite MDADI scores differentiated feeding tube dependent from non-tube dependent patients, aspirators from non-aspirators, and distinct PSS-HN diet levels. We identify that a 10 point between-group difference in composite MDADI scores was associated with clinically meaningful between-group differences in swallowing function.