Patient self-perceptions of swallowing difficulties as compared to expert ratings of videofluorographic studies.

BACKGROUND/AIMS Research investigating the relationship between subjective and objective assessment of dysphagia in patients with various diagnoses has yielded conflicting results. The goal of this study is to investigate the reliability of patient self-perceptions of swallowing difficulties compared to expert ratings of videofluorographic studies considering three medical diagnostic categories: neurological disorders, structural deficits and general medical diagnoses. METHODS One hundred and three patients who were referred for videofluorographic swallow evaluation were included in the study. Face-to-face interviews with patients were conducted before their videofluorographic studies. The correlation between patient self-perceptions and expert ratings of the videofluorographic studies was established by comparing the results of patients' self-reports with the results of the videofluorographic studies. RESULTS The correlation between patient self-perceptions of swallowing difficulties and expert ratings of the videofluorographic studies varied greatly depending on the patients' medical diagnoses. The correlation was mild in patients with neurological disorders, moderate in patients with structural deficits and high in patients with general medical diagnoses. CONCLUSION The results of this study demonstrated that patient self-perceptions of swallowing difficulties should be used as one of the criteria, but not the only one, in making referrals for further swallowing evaluation, especially in patients with neurological disorders.