中文版Ohkuma问卷调查量表和中文版EAT-10在老年人群吞咽障碍风险筛查中的预测效能比较OA

Objective To compare the predictive efficacy of the Chinese version of the Ohkuma Questionnaire and the Chi-nese version of the eating assessment tool-10(EAT-10)in screening for dysphagia risk in the elderly population.Methods A conve-nience sampling method was used.Ninety-nine elderly patients admitted to the Cardiovascular and Geriatrics Departments of the Third Affiliated Hospital of Sun Yat-Sen University and the Fifth Affiliated Hospital of Guangzhou Medical University from Septem-ber to November 2022 were screened.A total of 99 questionnaires were distributed.Six questionnaires were excluded due to contra-dictory responses among item options,resulting in 93 valid questionnaires.General demographic information of the participants was collected using a general demographic questionnaire.Reliability was assessed using Cronbach's α to evaluate the internal consisten-cy of the two scales.Item-to-total correlations were analyzed using Spearman's rank correlation coefficient.For construct validity,Kaiser-Meyer-Olkin(KMO)test and Bartlett's test of sphericity were carried out,followed by exploratory factor analysis(EFA),with the number of factors determined using principal component analysis(PCA).Common factors were then extracted based on the criterion of eigenvalues greater than 1,and the cumulative variance contribution rate was computed.Factor loading coefficients were derived by multiplying eigenvectors by the square root of their corresponding eigenvalues.Dysphagia was screened using the Chi-nese versions of the Ohkuma questionnaire and the Chinese version of the EAT-10.The presence of dysphagia was determined by videofluoroscopic swallowing study(VFSS),and the screening results were compared against the VFSS diagnosis.Receiver oper-ator characteristic(ROC)curves and the area under the curve(AUC)were employed to determine the optimal cutoff points.Sensitiv-ity,specificity,Youden's index,and other indicators were then applied to compare the predictive performance of the two scales for dysphagia risk screening in the elderly population.Results the Cronbach's α of the Chinese version of the Ohkuma Questionnaire was 0.843,indicating good internal consistency and reliability.All item-total correlations were positive(P<0.05),with Spearman cor-relation coefficients r ranging from 0.289 to 0.805.The Chinese version of the Ohkuma questionnaire demonstrated a Kaiser-Meyer-Olkin(KMO)value of 0.741 and Bartlett's test of sphericity x²=823.000(P<0.05),supporting for EFA.Three common factors were extracted by PCA,accounting for 63.23%of the total variance.The factor loadings ranged from 0.34 to 0.92.The Cronbach's α of the Chinese version of the EAT-10 was 0.698,which approximated 0.7,indicating acceptable reliability.All item-total correlations,excluding for item 6 were positive,and the correlations with the total score were statistically significant(P<0.05),with Spearman correlation coefficients r ranging from 0.391 to 0.730.The KMO value of the Chinese EAT-10 was 0.663,and Bartlett's test of sphe-ricity showed a x²=324.735(P<0.05).Two common factors were extracted by PCA,accounting for 49.75%of the total variance.The factor loadings ranged from 0.16 to 1.06.Among the 37 participants screened as positive by the Chinese version of the Ohkuma ques-tionnaire,29 were diagnosed as positive and 8 as negative by VFSS.Among 56 participants identified as negative by the Chinese version of the Ohkuma questionnaire,VFSS indicated 5 were positive and 51 were negative.Among the 26 participants screened as positive by the Chinese version of the EAT-10,VFSS confirmed 16 as true positive and 10 as negative.Among the 67 participants screened as negative,VFSS identified 18 as positive and 49 as true negative.The Chinese version of the Ohkuma questionnaire had an AUC of 0.867.The sensitivity for detecting dysphagia was 86.11%,and the specificity was 87.30%.The positive predictive value(PPV)was 78.37%,and the negative predictive value(NPV)was 91.07%.The Youden's index was determined to be 0.73.The AUC of the Chinese version of the EAT-10 was 0.643,with a sensitivity of 44.44%,a specificity of 84.13%,a PPV of 61.54%,a NPV of 73.13%,and a Youden's index of 0.29.Conclusion The Chinese version of the Ohkuma questionnaire demonstrated better effective-ness than the Chinese version of the EAT-10 in identifying the risk of dysphagia in the elderly population,with relatively good sensi-tivity and specificity.