TY  - GEN
A1  - Frank, Ulrike
A1  - Radtke, Julia
A1  - Nienstedt, Julie Cläre
A1  - Pötter-Nerger, Monika
A1  - Schönwald, Beate
A1  - Buhmann, Carsten
A1  - Gerloff, Christian
A1  - Niessen, Almut
A1  - Flügel, Till
A1  - Koseki, Jana-Christiane
A1  - Pflug, Christina
T1  - Dysphagia screening in Parkinson's Disease
BT  - a diagnostic accuracy cross-sectional study investigating the applicability of the Gugging Swallowing Screen (GUSS)
T2  - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
N2  - Background
Simple water-swallowing screening tools are not predictive of aspiration and dysphagia in patients with Parkinson's Disease (PD). We investigated the diagnostic accuracy of a multi-texture screening tool, the Gugging Swallowing Screen (GUSS) to identify aspiration and dysphagia/penetration in PD patients compared to flexible endoscopic evaluation of swallowing (FEES). 

Methods
Swallowing function was evaluated in 51 PD participants in clinical 'on-medication' state with the GUSS and a FEES examination according to standardized protocols. Inter-rater reliability and convergent validity were determined and GUSS- and FEES-based diet recommendations were compared. 

Key Results
Inter-rater reliability of GUSS ratings was high (r(s) = 0.8; p < 0.001). Aspiration was identified by the GUSS with a sensitivity of 50%, and specificity of 51.35% (PPV 28%, NPV 73%, LR+ 1.03, LR- 0.97), dysphagia/penetration was identified with 72.97% sensitivity and 35.71% specificity (PPV 75%, NPV 33.33%, LR+ 1.14, LR- 0.76). Agreement between GUSS- and FEES-based diet recommendations was low (r(s) = 0.12, p = 0.42) with consistent NPO (Nil per Os) allocation by GUSS and FEES in only one participant.

Conclusions and Inferences
The multi-texture screening tool GUSS in its current form, although applicable with good inter-rater reliability, does not detect aspiration in PD patients with acceptable accuracy. Modifications of the GUSS parameters "coughing," "voice change" and "delayed swallowing" might enhance validity. The GUSS' diet recommendations overestimate the need for oral intake restriction in PD patients and should be verified by instrumental swallowing examination.
T3  - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 854 
KW  - aspiration
KW  - dysphagia
KW  - FEES
KW  - Gugging Swallowing Screen
KW  - Parkinson' s disease
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-569625
SN  - 1866-8364
IS  - 5
ER  -