目的 探讨进食评估问卷调查工具-10(EAT-10)中文版在急性期脑卒中患者口咽期吞咽障碍(OD)筛查中的敏感度及特异度.方法 采用EAT-10中文版对130名急性期脑卒中后住院患者进行筛查评估,筛查当天行视频透视检查(VFS),选用受试者工作曲线(ROC曲线)调整分界值,用敏感度、特异度、Youden指数、阳性预测值、阴性预测值、阳性似然比、阴性似然比进行筛查效果评价.结果 根据ROC曲线调查分界值,分界值选1时,EAT-10中文版的敏感度较高(77.9%)、阴性预测值也较高(73.2%),特异度为66.1%,Youden指数0.46,阳性预测值71.6%,阳性似然比2.30,阴性似然比0.33.EAT-10中文版重测信度均0.7以上,不同调查员信度较好,显示条目2有1位调查员的结果是恒定值.量表其余9个条目的一致相关系数均>0.7,各亚项和总分均值间一致性较高.结论 EAT-10中文版重测信度和不同调查员信度较好,分界值选1为最理想分界值,EAT-10中文版得分≥1时判断吞咽异常有较高的敏感度及阴性预测值,推荐作为急性期脑卒中后吞咽障碍筛查工具.
Objective To study the sensitivity and specificity of the Chinese eating assessment tool (EAT-10) in screening acute stroke patients for oropharyngeal dysphagia (OD).Methods A total of 130 inpatients with acute stroke were screened using the Chinese EAT-10.On the same day they were also screened using the gold standard technique for diagnosing dysphasia-videofluoroscopy.A receiver operating characteristics (ROC) curve was developed to study EAT-10's sensitivity and specificity.A Youden index,positive predictive value (PPV),negative predictive value (NPV),and positive and negative likelihood ratios (LHR+ and LHR) were quantified.Results According to the ROC curve,a cut-off point of 1 (EAT-10 score≥ 1) gave the best sensitivity (77.9%),the highest NPV (73.2%),with 66.1% specificity,71.6% PPV,2.30 LHR+ and 0.33 LHR in screening for OD.The test-retest reliability was above 0.7.An investigator consistency reliability test showed good repeatability,and the consistency between each item and the mean total score was high.Conclusion The Chinese EAT-10 has good test-retest reliability and investigator consistency.The optimal cut-off point is 1,with good sensitivity and NPV at scores ≥ 1.The test can be recommended as a screening tool for OD in acute stroke patients.