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Dysphagia

Open Access 16-05-2024 | Flexible Endoscopic Evaluation of Swallowing | Original Article

Validity and Reliability of the Swedish Version of the Gugging Swallowing Screen for use in Acute Stroke Care

Authors: Jenny Selg, Thorbjörn Holmlund, Eva Levring Jäghagen, Jenny McGreevy, Sara Svanberg, Per Wester, Patricia Hägglund

Published in: Dysphagia

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Abstract

The purpose of this study was to cross-culturally validate the Swedish version of the Gugging Swallowing Screen (GUSS-S) for use in the acute phase of stroke. Further, to evaluate the inter-rater reliability between different healthcare professionals. GUSS was translated into Swedish using a forward-backward method followed by expert rating to obtain content validity. For criterion validity, the GUSS-S score was compared with Flexible Endoscopic Evaluation of Swallowing (FEES) assessed with the Penetration-Aspiration Scale (PAS) in acute stroke patients (≤ 96 h after stroke onset). Convergent validity was calculated by comparison with the Functional Oral Intake Scale (FOIS) as per the comprehensive FEES assessment, the Standardized Swallowing Assessment (SSA), and the National Institutes of Health Stroke Scale (NIHSS). To evaluate inter-rater reliability, a nurse and a speech-language pathologist (SLP) independently assessed 30 patients. In total, 80 patients (32 women, median age 77 years (range 29–93) were included, mean 1.7 ± 0.9 days after admission. With a cut-off value of 14 points, the GUSS-S identified aspiration with a sensitivity of 100% and a specificity of 73% (area under the curve: 0.87, 95% CI 0.78–0.95). Spearman rank correlation showed very strong correlation between the GUSS-S and PAS (rs=-0.718, P = < 0.001) and FOIS (rs=0.720, P = 0.001) and strong correlation between the GUSS-S and SSA (rs=0.545, P = < 0.001) and NIHSS (rs=-0.447, P = 0.001). The inter-rater agreement for GUSS-S was substantial (Kw=0.67, P = < 0.001). The results indicate that the GUSS-S is a valid and reliable tool for the assessment of dysphagia in acute stroke patients by different healthcare professionals.
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Metadata
Title
Validity and Reliability of the Swedish Version of the Gugging Swallowing Screen for use in Acute Stroke Care
Authors
Jenny Selg
Thorbjörn Holmlund
Eva Levring Jäghagen
Jenny McGreevy
Sara Svanberg
Per Wester
Patricia Hägglund
Publication date
16-05-2024
Publisher
Springer US
Published in
Dysphagia
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-024-10717-y