1
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Schepers FV, van Hulst K, Spek B, Erasmus CE, van den Engel‐Hoek L. Dysphagia limit in children with cerebral palsy aged 4 to 12 years. Dev Med Child Neurol 2022; 64:253-258. [PMID: 34418067 PMCID: PMC9291064 DOI: 10.1111/dmcn.15031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 12/02/2022]
Abstract
AIM To assess the dysphagia limit in children with cerebral palsy (CP) according to Eating and Drinking Ability Classification System (EDACS) level, sex, and age compared to typically developing children. METHOD Seventy-seven children with CP (54 males, 23 females; mean age 7y 6mo, SD 2y 2mo, age range 4-12y) were assessed with the Maximum Volume Water Swallow Test. Median dysphagia limit in the CP group was compared with data of typically developing children. RESULTS The dysphagia limit of children with CP differed significantly (p<0.001) from typically developing children. The latter showed a threefold higher median dysphagia limit (22mL) compared to children with CP in EDACS level I (7mL). The higher the EDACS level, the lower the dysphagia limit in children with CP. EDACS level explained 55% of the variance in the dysphagia limit of the CP group. INTERPRETATION Where children with CP in EDACS levels IV and V showed that their capacity met the level of their performance, children in EDACS level I had the ability to perform a maximum capacity task, but still had a threefold lower median dysphagia limit than typically developing children. Establishment of the dysphagia limit should be part of general swallowing assessment in children with CP.
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Affiliation(s)
- Florentine V Schepers
- Department of Rehabilitation MedicineUniversity Medical Centre GroningenUniversity of GroningenGroningenthe Netherlands
| | - Karen van Hulst
- Department of RehabilitationDonders Institute for Brain, Cognition and BehaviourRadboud University Medical CentreAmalia Children’s HospitalNijmegenthe Netherlands
| | - Bea Spek
- Department of Epidemiology and DatascienceAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamthe Netherlands
| | - Corrie E Erasmus
- Department of Paediatric NeurologyDonders Institute for Brain, Cognition and BehaviourRadboud University Medical CentreAmalia Children’s HospitalNijmegenthe Netherlands
| | - Lenie van den Engel‐Hoek
- Department of RehabilitationDonders Institute for Brain, Cognition and BehaviourRadboud University Medical CentreAmalia Children’s HospitalNijmegenthe Netherlands
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2
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Riyahi A, Rassafiani M, Nobakht Z, Abdolrazaghi H, Moradzadeh R. Validity and reliability of the Persian version of the Eating and Drinking Ability Classification System. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2017.0176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/AimsThe ability to eat and drink is the most important factor in health, survival and longevity. Children with cerebral palsy can suffer from severe dysphagia, which can lead to a high risk of aspiration and choking. As classifying eating and drinking ability in children with cerebral palsy is important in research and treatment, the aim of this study was to determine the cross-cultural validation and reliability of the Persian version of the Eating and Drinking Ability Classification System.MethodsAfter translation procedures, the face validity, content validity, test–retest reliability and interrater reliability of the Eating and Drinking Ability Classification System were evaluated. In total, 130 parents of children with cerebral palsy and 34 therapists participated in the evaluation of the scale's reliability. The 73 boys and 57 girls with cerebral palsy were aged 3–20 years (mean age 4.4 years) and had various types of cerebral palsy. They were classified according to the Eating and Drinking Ability Classification System by both their parents and the therapists.ResultsThe overall results indicated that the words and sentences used were simple, clear, understandable, relevant and necessary. The intraclass correlation coefficients for test–retest reliability for parents, occupational therapists and speech therapists were 0.98, 0.98 and 0.995, respectively. The interrater reliability between parents and occupational therapists was 0.96, between parents and speech therapists was 0.95, and between occupational therapists and speech therapists was 0.985.ConclusionsThe Persian version of the Eating and Drinking Ability Classification System seems to be valid and reliable. This system may be used to evaluate children with cerebral palsy.
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Affiliation(s)
- Azade Riyahi
- Instructor, Department of Occupational Therapy, School of Rehabilitation, Arak University of Medical Sciences, Arak, Iran
| | - Mehdi Rassafiani
- Associate Professor, Occupational Therapy Department, Faculty of Allied Health Sciences, Health Science Center, Kuwait University, Kuwait
| | - Zahra Nobakht
- Assistant Professor, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hosseinali Abdolrazaghi
- Assistant Professor, Department of Hand and Reconstructive Surgery, Sina Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Rahmatollah Moradzadeh
- Assistant Professor, Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
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3
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Sellers D, Bryant E, Hunter A, Campbell V, Morris C. The Eating and Drinking Ability Classification System for cerebral palsy: A study of reliability and stability over time. J Pediatr Rehabil Med 2019; 12:123-131. [PMID: 31227668 DOI: 10.3233/prm-180581] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AIM This study evaluated the inter-observer reliability and stability over time of the Eating and Drinking Ability Classification System (EDACS) for children and young people with cerebral palsy (CP). METHOD Case records for 97 children with CP were examined to collect retrospective data about eating and drinking abilities at four time-points with a minimum of 2 years between each time-point. Sex, Gross Motor Function Classification System (GMFCS) level, presence of feeding tube and orthopaedic issues were recorded from case records. One speech and language therapist (SaLT1) classified eating and drinking ability using EDACS for all cases at all time-points; SaLT2 assigned EDACS levels for 50 cases at time-point 1; SaLT3 assigned EDACS levels for 24 cases at all time-points. Inter-observer reliability and stability over time were assessed using the Intraclass Correlation Coefficient (ICC). Associations between EDACS levels and functioning recorded with other Functional Classification Systems (FCSs) were calculated using Kendall's tau (τ). RESULTS Out of 97 children, 48 were male, 48 had feeding tubes, and 83 had orthopaedic issues. ICC for EDACS levels recorded by SaLT1 across all time-points was 0.97 (95% CI 0.96-0.98); changes in EDACS levels occurred infrequently and never by more than one level. ICC between SaLT1 and SaLT2 at time-point 1 was 0.8 (95% CI 0.67-0.89); ICC between SaLT1 and SaLT3 across all time-points was 0.95 (95% CI 0.92-0.98). Association between GMFCS and EDACS was moderate (τ= 0.58). INTERPRETATION Retrospective use of EDACS to classify children's eating and drinking abilities appears reliable; EDACS appeared stable over 6 or more years in 86% of the cases.
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Affiliation(s)
- Diane Sellers
- Chailey Clinical Services, Sussex Community NHS Foundation Trust, Brighton, East Sussex, UK
| | - Elizabeth Bryant
- Chailey Clinical Services, Sussex Community NHS Foundation Trust, Brighton, East Sussex, UK.,School of Health Sciences, University of Brighton, Brighton, East Sussex, UK
| | - Alison Hunter
- Chailey Clinical Services, Sussex Community NHS Foundation Trust, Brighton, East Sussex, UK
| | - Vivienne Campbell
- Chailey Clinical Services, Sussex Community NHS Foundation Trust, Brighton, East Sussex, UK
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4
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Stang KM, King NE, Gaebler-Spira D. It all started with a clubfoot: Beliefs surrounding cerebral palsy throughout history. J Pediatr Rehabil Med 2019; 12:115-121. [PMID: 31282435 DOI: 10.3233/prm-190005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Nicholas E King
- University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Deborah Gaebler-Spira
- Department of Physical Medicine and Rehabilitation and Pediatrics, Feinberg Northwestern School of Medicine, Rehabilitation Institute of Chicago, Chicago, IL, USA
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5
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Sellers D. Eating and Drinking Ability Classification System. Dysphagia 2018; 34:279-280. [PMID: 30232549 DOI: 10.1007/s00455-018-9943-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 09/05/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Diane Sellers
- Chailey Clinical Services, Sussex Community NHS Foundation Trust, Beggars Wood Road, North Chailey, Nr Lewes, East Sussex, BN8 4JN, UK.
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6
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Tschirren L, Bauer S, Hanser C, Marsico P, Sellers D, van Hedel HJA. The Eating and Drinking Ability Classification System: concurrent validity and reliability in children with cerebral palsy. Dev Med Child Neurol 2018; 60:611-617. [PMID: 29656386 DOI: 10.1111/dmcn.13751] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/03/2018] [Indexed: 11/28/2022]
Abstract
AIM As there is little evidence for concurrent validity of the Eating and Drinking Ability Classification System (EDACS), this study aimed to determine its concurrent validity and reliability in children and adolescents with cerebral palsy (CP). METHOD After an extensive translation procedure, we applied the German language version to 52 participants with CP (30 males, 22 females, mean age 9y 7mo [SD 4y 2mo]). We correlated (Kendall's tau or Kτ ) the EDACS levels with the Bogenhausener Dysphagiescore (BODS), and the EDACS level of assistance with the Manual Ability Classification System (MACS) and the item 'eating' of the Functional Independence Measure for Children (WeeFIM). We further quantified the interrater reliability between speech and language therapists (SaLTs) and between SaLTs and parents with Kappa (κ). RESULTS The EDACS levels correlated highly with the BODS (Kτ =0.79), and the EDACS level of assistance correlated highly with the MACS (Kτ =0.73) and WeeFIM eating item (Kτ =-0.80). Interrater reliability proved almost perfect between SaLTs (EDACS: κ=0.94; EDACS level of assistance: κ=0.89) and SaLTs and parents (EDACS: κ=0.82; EDACS level of assistance: κ=0.89). INTERPRETATION The EDACS levels and level of assistance seem valid and showed almost perfect interrater reliability when classifying eating and drinking problems in children and adolescents with CP. WHAT THIS PAPER ADDS The Eating and Drinking Ability Classification System (EDACS) correlates well with a dysphagia score. The EDACS level of assistance proves valid. The German version of EDACS is highly reliable. EDACS correlates moderately to highly with other classification systems.
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Affiliation(s)
- Lea Tschirren
- Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Fakultät für Gesundheit und Medizin, Donau-Universität Krems, Krems, Austria
| | - Susanne Bauer
- Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Department of Special Education, University of Fribourg, Fribourg, Switzerland
| | - Chiara Hanser
- Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Affoltern am Albis, Switzerland
| | - Petra Marsico
- Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Diane Sellers
- Sussex Community NHS Foundation Trust, Chailey Clinical Services, North Chailey, East Sussex, UK
| | - Hubertus J A van Hedel
- Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
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7
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Backman E, Karlsson AK, Sjögreen L. Gastrostomy Tube Feeding in Children With Developmental or Acquired Disorders: A Longitudinal Comparison on Healthcare Provision and Eating Outcomes 4 Years After Gastrostomy. Nutr Clin Pract 2018; 33:576-583. [DOI: 10.1002/ncp.10056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ellen Backman
- School of Health and Welfare; Halmstad University; Sweden
- Regional Habilitation Center; Region Halland; Kungsbacka Sweden
| | | | - Lotta Sjögreen
- Mun-H-Center Orofacial Resource Center for Rare Diseases; Public Dental Service; Gothenburg Sweden
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8
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van Hulst K, Snik DAC, Jongerius PH, Sellers D, Erasmus CE, Geurts ACH. Reliability, construct validity and usability of the Eating and Drinking Ability Classification System (EDACS) among Dutch children with Cerebral Palsy. J Pediatr Rehabil Med 2018; 11:115-124. [PMID: 30010151 DOI: 10.3233/prm-170515] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To assess the interrater reliability, construct validity and usability of the Eating and Drinking Ability Classification System (EDACS) among Dutch children with Cerebral Palsy (CP) when used by speech and language therapists (SLTs) familiar and unfamiliar with the child's eating and drinking performance and parents. METHODS Translation was undertaken using the method of Eremenco. Agreement between SLTs and parents when using EDACS was determined by intraclass correlation coefficient (ICC) and linear weighted Kappa (κW). Associations with other functional classification systems including the Dysphagia Management Staging Scale (DMSS) were investigated to determine construct validity by Kendall's tau-b. RESULTS Thirty-one SLTs classified 149 children (67 girls; mean 10 y, SD 4 y, range 3-21 y) with EDACS. Pairs of SLTs showed good agreement ([ICC] = 0.84; 95% confidence interval [CI] 0.79-0.88; [κW] = 0.71). Eighty-one parents showed good agreement with SLTs (n= 31) as well (ICC = 0.80; 95% CI 0.71-0.87; κW= 0.61). There was a significant and strong positive correlation of EDACS with DMSS (Kendall's tau-b 0.81) supporting its construct validity. Usability of EDACS was generally good. CONCLUSION The Dutch version of EDACS is reliable and valid, and can be used easily by (familiar and unfamiliar) SLTs and parents of children with CP. Parents and professionals showed a high level of consistency when classifying eating and drinking abilities. EDACS enables uniform and efficient communication about safety and efficiency of functional eating and drinking ability in clinical and research contexts.
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Affiliation(s)
- Karen van Hulst
- Departments of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dorinda A C Snik
- Departments of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Rehabilitation, Rehabilitation Centre Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Pieter H Jongerius
- Departments of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Corrie E Erasmus
- Departments of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alexander C H Geurts
- Departments of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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9
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Goh YR, Choi JY, Kim SA, Park J, Park ES. Comparisons of severity classification systems for oropharyngeal dysfunction in children with cerebral palsy: Relations with other functional profiles. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 72:248-256. [PMID: 29223113 DOI: 10.1016/j.ridd.2017.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 10/02/2017] [Accepted: 12/01/2017] [Indexed: 05/28/2023]
Abstract
This study aimed to investigate the relationships between various classification systems assessing the severity of oropharyngeal dysphagia and communication function and other functional profiles in children with cerebral palsy (CP). This is a prospective, cross-sectional, study in a university-affiliated, tertiary-care hospital. We recruited 151 children with CP (mean age 6.11 years, SD 3.42, range 3-18yr). The Eating and Drinking Ability Classification System (EDACS) and the dysphagia scales of Functional Oral Intake Scale (FOIS), Swallow Function Scales (SFS), and Food Intake Level Scale (FILS) were used. The Communication Function Classification System (CFCS) and Viking Speech Scale (VSS) were employed to classify communication function and speech intelligibility, respectively. The Pediatric Evaluation of Disability Inventory (PEDI) with the Gross Motor Function Classification System (GFMCS) and the Manual Ability Classification System (MACS) level were also assessed. Spearman correlation analysis to investigate the associations between measures and univariate and multivariate logistic regression models to identify significant factors were used. Median GMFCS level of participants was III (interquartile range II-IV). Significant dysphagia based on EDACS level III-V was noted in 23 children (15.2%). There were strong to very strong relationships between the EDACS level with the dysphagia scales. The EDACS presented strong associations with MACS, CFCS, and VSS, a moderate association with GMFCS level, and a moderate to strong association with each domain of the PEDI. In multivariate analysis, poor functioning in EDACS were associated with poor functioning in gross motor and communication functions.
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Affiliation(s)
- Yu-Ra Goh
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ja Young Choi
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seon Ah Kim
- Department of Pediatric Occupational Therapy, Severance Rehabilitation Hospital, Seoul, Republic of Korea
| | - Jieun Park
- Department of Rehabilitation Speech-Language Therapy, Severance Rehabilitation Hospital, Seoul, Republic of Korea
| | - Eun Sook Park
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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10
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Nip ISB, Wilson EM, Kearney L. Spatial Characteristics of Jaw Movements During Chewing in Children with Cerebral Palsy: A Pilot Study. Dysphagia 2017; 33:33-40. [PMID: 28795229 DOI: 10.1007/s00455-017-9830-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 07/29/2017] [Indexed: 11/26/2022]
Abstract
This study compared jaw motion between children with cerebral palsy (CP) and their typically-developing (TD) peers during chewing. The jaw movements of 11 children with spastic CP (GMFCS levels II-V) all of whom were exclusively oral feeders with no reported clinical issues with feeding [mean age = 7.49 (2.30) years; 7 males, 4 females] and 11 age- and sex-matched TD peers [mean age = 7.54 (2.35) years] were recorded using optical motion capture. Participants chewed five trials of three different consistencies, including puree, mechanical soft, and solid. For each chewing sequence, the path distance (total amount of distance traveled by the jaw), average jaw speed, and working space (total 3-dimensional size of the jaw movements during chewing) were calculated. The CP group had greater path distances for mechanical soft and solids (p < 0.001) and larger working spaces (p < 0.001) than the TD group. Consistency differences were also found with path distances increasing for both groups with increased bolus consistency (p < 0.001). Puree was chewed most slowly for both groups (p = 0.05) and was associated with smaller working space than the other consistencies for both groups (p < 0.001). The TD group demonstrated slower speeds for mechanical soft as compared to solids (p = 0.05), a finding which was not observed in the CP group. The results suggest children with CP showed jaw movement differences during chewing despite being exclusive oral eaters with no reports of clinical feeding or deglutition disorders. Food consistency also influenced jaw movements in both children with CP and their TD peers.
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Affiliation(s)
- Ignatius S B Nip
- School of Speech, Language and Hearing Sciences, San Diego State University, San Diego, CA, USA.
| | - Erin M Wilson
- Speech and Feeding Disorders Laboratoray, MGH Institute of Health Professions, Boston, MA, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Lucia Kearney
- School of Speech, Language and Hearing Sciences, San Diego State University, San Diego, CA, USA
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11
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Benfer KA, Weir KA, Bell KL, Ware RS, Davies PSW, Boyd RN. The Eating and Drinking Ability Classification System in a population-based sample of preschool children with cerebral palsy. Dev Med Child Neurol 2017; 59:647-654. [PMID: 28276586 DOI: 10.1111/dmcn.13403] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2017] [Indexed: 12/24/2022]
Abstract
AIM To determine (1) the reproducibility of the Eating and Drinking Ability Classification System (EDACS); (2) EDACS classification distribution in a population-based cohort with cerebral palsy (CP); and (3) the relationships between the EDACS and clinical mealtime assessment, other classifications, and health outcomes. METHOD This was a cross-sectional population-based cohort study of 170 children with CP at 3 years to 5 years (mean 57.6mo, standard deviation [SD] 8.3mo; 105 males, n=65 females). Functional abilities were representative of a population sample (Gross Motor Function Classification System level I=74, II=34, III=21, IV=18, V=23). The EDACS was the primary classification of mealtime function. The Dysphagia Disorders Survey was the clinical mealtime assessment. Gross motor function was classified using the Gross Motor Function Classification System. RESULTS EDACS classification had 88.3% intrarater agreement (κ=0.84, intraclass correlation coefficient=0.95; p<0.001) and 51.7% interrater agreement (κ=0.36, intraclass correlation coefficient=0.79; p<0.001). In total, 56.5% of children were classified as EDACS level I. There was a strong stepwise relationship between the Dysphagia Disorders Survey and EDACS (r=0.96, p<0.001). Parental stress (odds ratio=1.3, p=0.05) and feeding tubes (odds ratio=6.4, p<0.001) were significantly related to more limited function on the EDACS. INTERPRETATION The EDACS presents a viable adjunct to clinical assessment of feeding skills in children with CP for use in surveillance trials and clinical practice. A rating addendum would be a useful contribution to the tool to enhance reproducibility.
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Affiliation(s)
- Katherine A Benfer
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
| | - Kelly A Weir
- Menzies Health Institute of Queensland, Griffith University, Gold Coast, Qld, Australia.,Gold Coast University Hospital, Gold Coast Health, Gold Coast, Qld, Australia
| | - Kristie L Bell
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia.,Children's Nutrition Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
| | - Robert S Ware
- Menzies Health Institute of Queensland, Griffith University, Gold Coast, Qld, Australia.,Queensland Centre for Intellectual and Developmental Disability, The University of Queensland, Brisbane, Qld, Australia
| | - Peter S W Davies
- Children's Nutrition Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
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12
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Terwee CB, Prinsen CAC, Ricci Garotti MG, Suman A, de Vet HCW, Mokkink LB. The quality of systematic reviews of health-related outcome measurement instruments. Qual Life Res 2015; 25:767-79. [PMID: 26346986 PMCID: PMC4830864 DOI: 10.1007/s11136-015-1122-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Systematic reviews of outcome measurement instruments are important tools for the selection of instruments for research and clinical practice. Our aim was to assess the quality of systematic reviews of health-related outcome measurement instruments and to determine whether the quality has improved since our previous study in 2007. METHODS A systematic literature search was performed in MEDLINE and EMBASE between July 1, 2013, and June 19, 2014. The quality of the reviews was rated using a study-specific checklist. RESULTS A total of 102 reviews were included. In many reviews the search strategy was considered not comprehensive; in only 59 % of the reviews a search was performed in EMBASE and in about half of the reviews there was doubt about the comprehensiveness of the search terms used for type of measurement instruments and measurement properties. In 41 % of the reviews, compared to 30 % in our previous study, the methodological quality of the included studies was assessed. In 58 %, compared to 55 %, the quality of the included instruments was assessed. In 42 %, compared to 7 %, a data synthesis was performed in which the results from multiple studies on the same instrument were somehow combined. CONCLUSION Despite a clear improvement in the quality of systematic reviews of outcome measurement instruments in comparison with our previous study in 2007, there is still room for improvement with regard to the search strategy, and especially the quality assessment of the included studies and the included instruments, and the data synthesis.
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Affiliation(s)
- C B Terwee
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - C A C Prinsen
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | | | - A Suman
- Department of Public Health and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - H C W de Vet
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - L B Mokkink
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
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13
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Horridge K, Tennant PWG, Balu R, Rankin J. Variation in health care for children and young people with cerebral palsies: a retrospective multicentre audit study. Dev Med Child Neurol 2015; 57:844-51. [PMID: 25808699 DOI: 10.1111/dmcn.12740] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2015] [Indexed: 11/27/2022]
Abstract
AIM To explore the provision and variations in care for children and young people with cerebral palsies (CP) registered with the population-based North of England Collaborative Cerebral Palsy Survey (NECCPS). METHOD This is a retrospective multicentre record audit of 389 children with CP (220 males, 148 females, 21 no data; median age at time of audit 12y 3mo), born between 1995 and 2002. Data were collected on cranial magnetic resonance imaging (MRI), hip and spine surveillance and management, and pain presence and management. Variations over time and between the districts in the north of England (Northumberland, North and West Cumbria, North and South Tyneside, Newcastle-upon-Tyne, Gateshead, Sunderland, Durham, Darlington, Bishop Auckland, Hartlepool, Stockton-on-Tees, Middlesbrough, Redcar, and Cleveland), and by socio-economic status (SES) (estimated from the Index of Multiple Deprivation [IMD] 2004) were estimated by generalized estimating equations. RESULTS There was significant variation between districts in access to MRI (p<0.001), orthopaedic surgeons (p=0.005), recording state of spine (p<0.001), and discussions about pain (p<0.001). Fifty-seven per cent (95% CI 52-62) had evidence of a reported MRI brain scan, the proportion of which increased over time (p<0.001). Sixty-seven per cent (95% CI 62-71) had a discussion about pain recorded. Of those in pain, 87% (95% CI 80-93) had a pain management plan. The proportion with documented discussion about pain increased with increasing SES (p=0.04). INTERPRETATION The provision of care for children with CP in the north of England varies between districts. Internationally agreed, evidence-based standards are urgently needed to ensure more equitable health care and improved outcomes for all.
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Affiliation(s)
- Karen Horridge
- City Hospitals Sunderland NHS Foundation Trust, Sunderland Royal Hospital, Sunderland, UK
| | - Peter W G Tennant
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Rajesh Balu
- County Durham and Darlington NHS Foundation Trust, Durham, UK
| | - Judith Rankin
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.,PHE: Regional Maternity Survey Office, Newcastle upon Tyne, UK
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Sellers D, Mandy A, Pennington L, Hankins M, Morris C. Development and reliability of a system to classify the eating and drinking ability of people with cerebral palsy. Dev Med Child Neurol 2014; 56:245-51. [PMID: 24344767 DOI: 10.1111/dmcn.12352] [Citation(s) in RCA: 146] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/17/2013] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to develop a valid classification system to describe eating and drinking ability in people with cerebral palsy (CP), and to test its reliability. METHOD The Eating and Drinking Ability Classification System (EDACS) was developed in four stages in consultation with individuals with CP, parents, and health professionals: Stage 1, drafting informed by literature and clinical experience; Stage 2, modification by nominal groups; Stage 3, refinement in an international Delphi survey; and Stage 4, testing of agreement and reliability between classifications made by speech and language therapists (SaLTs), and between SaLTs and parents. RESULTS Seven nominal groups involved 56 participants; 95 people participated in two rounds of the Delphi survey. Using the version of EDACS produced from this process, SaLTs in pairs classified 100 children. The rate of absolute agreement was 78% (kappa=0.72; intraclass correlation coefficient [ICC]=0.93; 95% confidence interval [CI] 0.90-0.95). Any disagreement was only by one level, with one exception. SaLTs and parents classified 48 children. The rate of absolute agreement was 58% (kappa=0.45, ICC=0.86; 95% CI 0.76-0.92). Parents either agreed with SaLTs or rated their children as more able by one level. INTERPRETATION The EDACS provides a valid and reliable system for classifying eating and drinking performance of people with CP, for use in both clinical and research contexts.
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Affiliation(s)
- Diane Sellers
- Chailey Heritage Clinical Services, Sussex Community NHS Trust, Lewes, UK
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