Validity and Reliability of the M.D. Anderson Dysphagia Inventory in Turkish Patients with Neurological Disease.

INTRODUCTION

Dysphagia is a prevalent symptom of various neurological diseases and is associated with decreased quality of life. The M.D. Anderson Dysphagia Inventory (MDADI) is globally utilized tool to assess the impact of dysphagia on quality of life. However, a Turkish version of the scale is not yet available. This study aimed to translate, culturally adapt, and evaluate the validity and reliability of the Turkish version of the MDADI.

METHODS

One hundred twenty-four patients who were diagnosed with definite neurological disease completed the study. The cross-cultural adaptation and translation process of the MDADI adhered to the World Health Organization's guidelines using the forward-backward translation method. The feasibility and the floor and ceiling effects were evaluated. Cronbach's alpha was used to assess internal consistency. The Bland and Altman method and interclass correlation coefficient (ICC) were used to evaluate test-retest reliability. Absolute reliability was determined using the standard error of the measurement (SEM) and minimal detectable change (MDC). Construct validity was assessed using Pearson's correlation coefficient between the MDADI and the Turkish Swallowing Quality of Life (T-SWAL-QOL) questionnaire.

RESULTS

Our study had a feasibility rate of 100%. No floor or ceiling effects were determined for any subscale or composite scores of the T-MDADI. The T-MDADI demonstrated excellent reliability, with Cronbach's alpha coefficients ranging from 0.89 to 0.96 and ICC values from 0.81 to 0.95, confirming strong internal consistency and test-retest reliability. Measurement precision was supported by a SEM of 3.96 and an MDC of 10.97 for the composite score. In terms of validity, significant correlations were observed between T-MDADI subdomains and T-SWAL-QOL subdomains (r = 0.61-0.80 for food selection, mental health, and social functioning; r = 0.41-0.60 for eating duration and communication; p < 0.01), demonstrating good to very good convergent validity.

CONCLUSION

The T-MDADI demonstrates validity and reliability as a questionnaire for assessing dysphagia-related quality of life in Turkish patients with neurological diseases.