Turkish Adaptation of Modified Mann Swallowing Ability Test in Patients with Acute Stroke: A Validity and Reliability Study

Abstract

702 Dysphagia is a symptom defined as impaired bolus formation or failure of safe passage of the bolus from the mouth into the stomach. 1 The incidence of dysphagia is 23% to 50% after stroke, and aspiration pneumonia resulting from dysphagia increases the mortality rate by 6 times. 2 Dysphagia causes life-threatening complications and increase in hospitalisation/care durations and treatment ABS TRACT Objective: The aim of the dysphagia screening test is to identify as many cases as possible before aspiration occurs. In Türkiye, there is a need for a practical and non-invasive screening test that evaluates swallowing pre-skills apart from comprehensive clinical tests. For this purpose, the Turkish validity and reliability of the Modified Mann Assessment of Swallowing Ability (MMASA) test were examined. Material and Methods: The test was translated into Turkish, and its content validity index was calculated. Then, the test was re-translated to English, and its compliance with the original version was evaluated. The generated Turkish MMASA (TR-MMASA) test was applied to 90 patients with acute stroke. Similar scale validity was evaluated by checking its compliance with the Turkish Mann Assessment of Swallowing Ability (T-MASA) test. The test-retest and interrater reliability methods were used for reliability analysis. Internal consistency (IC) and item-total correlation were examined. Results: Reliability was calculated according to intraclass correlation (ICC) coefficients (ICC=0.92, ICC=0.97). IC and item-total correlation coefficients were examined (Cronbach's alpha=0.91). For convergent and discriminant validity, T-MASA test was applied, and the Spearman's rho correlation coefficient was examined (r=0.88). As a result of the receiver operating characteristic analysis, the sensitivity (87%), specificity (88%), positive predictive value (0.77), negative predictive value (0.93), positive likelihood ratio (7.14) and negative likelihood ratio (0.14) percentages of the test were found valid. Conclusion: TR-MMASA test was found to be a valid and reliable screening test for bedside clinical evaluation in patients with acute stroke.