Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale.

Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale.

Arch Phys Med Rehabil. 2018 Feb 08;:

Authors: Steele CM, Namasivayam-MacDonald AM, Guida BT, Cichero JAY, Duivestein J, Hanson B, Lam P, Riquelme LF

Abstract
OBJECTIVE: To assess consensual validity, inter-rater reliability and criterion validity of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale (IDDSI-FDS), a new functional outcome scale intended to capture the severity of oropharyngeal dysphagia, as represented by the degree of diet texture restriction recommended for the patient.
DESIGN: Participants assigned IDDSI-FDS scores to 16 clinical cases. Consensual validity was measured against reference scores determined by an author reference panel. Inter-rater reliability was measured overall and across quartile subsets of the dataset. Criterion validity was evaluated versus Functional Oral Intake Scale (FOIS) scores assigned by survey respondents to the same case scenarios. Feedback was requested regarding ease and likelihood of use.
SETTING: Web-based survey.
PARTICIPANTS: 170 respondents from 29 countries.
INTERVENTIONS: N/A MAIN OUTCOME MEASURES: Consensual validity (% agreement, Kendall's tau), criterion validity (Spearman rank correlation), inter-rater reliability (Kendall's concordance and intra-class coefficients).
RESULTS: The IDDSI-FDS showed strong consensual validity, criterion validity and inter-rater reliability. Scenarios involving liquid-only diets, transition from non-oral feeding or trial diet advances in therapy showed the poorest consensus, indicating a need for clear instructions on how to score these situations. The IDDSI-FDS showed greater sensitivity than the FOIS to specific changes in diet. The majority (> 70%) of respondents indicated enthusiasm for implementing the IDDSI-FDS.
CONCLUSIONS: This initial validation study suggests that the IDDSI-Functional Diet Scale has strong consensual and criterion validity and can be used reliably by clinicians to capture diet texture restriction and progression in people with dysphagia.

PMID: 29428348 [PubMed - as supplied by publisher]

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