ArticleDysphagia2025
Validation of the Swedish Dynamic Imaging Grade of Swallowing Toxicity for Flexible Endoscopic Evaluation of Swallowing (DIGEST-FEES).
Article in Dysphagia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Mapping the DIGEST Decision Tree to the IDDSI Framework to Promote Reproducibility and Global Implementation.Dysphagia · 2026Article
- Precision rehabilitation for swallowing dysfunction after radiotherapy in head and neck cancer: current evidence, key controversies, and future perspectives.Frontiers in oncology · 2026Review
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Authors and funding
4 authors.
Funding
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Abstract
In the head and neck cancer (HNC) population around 45% suffer from chronic swallowing difficulties after cancer treatment. Previously a measure for flexible endoscopic evaluation of swallowing (FEES) where swallowing efficiency, safety and overall ability is evaluated within the same framework has been lacking. The Dynamic Imaging Grade of Swallowing Toxicity for FEES (DIGEST-FEES) was developed in 2021 and provides such a measure for patients with HNC. The aim of this study was to translate and validate the DIGEST-FEES into Swedish (Sw-DIGEST-FEES). A translation of the protocol to Swedish was done through forward-backward translation. Two raters rated eighty-nine FEES recordings according to the Sw-DIGEST-FEES and five reference measures of swallowing ability: Yale Pharyngeal Residue Severity Rating Scale, Swallowing Performance Scale, Murray Secretion Scale, MD Anderson Dysphagia Inventory and Penetration Aspiration Scale. Intra- and interrater reliability was analyzed. Construct validity was evaluated by correlating the Sw-DIGEST-FEES ratings to the reference measures. A priori hypothesis was that the correlations would correspond to those of the reference measures included in the original English version. The Sw-DIGEST-FEES demonstrated retained psychometric properties. Construct validity was good. 79% of correlations to the reference measures were equal to or stronger than those in the original development. Inter-rater agreement of the Sw-DIGEST-FEES ranged from substantial to almost perfect (0.76-0.81). Intra-rater reliability was in general almost perfect (0.8-1). The Sw-DIGEST-FEES can be considered a valid and reliable protocol for use in evaluation of swallowing function in HNC patients.
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