Qualitative assessment of the suitability of the Dysphagia Symptom Questionnaire to monitor dysphagia in children aged 7–10 years with eosinophilic esophagitis
Abstract Background The Dysphagia Symptom Questionnaire (DSQ) is a patient-reported outcome measure that assesses the frequency and severity of dysphagia in patients with eosinophilic esophagitis (EoE); however, it has only been validated for use in patients with EoE aged 11–40 years. This study exa...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2023-10-01
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| Series: | Journal of Patient-Reported Outcomes |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41687-023-00646-z |
| _version_ | 1827770551054106624 |
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| author | Robin M. Pokrzywinski Bridgett Goodwin Evan S. Dellon Ellyn Kodroff Anne Brooks Adam Bailey James Williams Nirav K. Desai |
| author_facet | Robin M. Pokrzywinski Bridgett Goodwin Evan S. Dellon Ellyn Kodroff Anne Brooks Adam Bailey James Williams Nirav K. Desai |
| author_sort | Robin M. Pokrzywinski |
| collection | DOAJ |
| description | Abstract Background The Dysphagia Symptom Questionnaire (DSQ) is a patient-reported outcome measure that assesses the frequency and severity of dysphagia in patients with eosinophilic esophagitis (EoE); however, it has only been validated for use in patients with EoE aged 11–40 years. This study examined the content validity of the DSQ and its usability on an electronic handheld device in children aged 7–10 years with EoE. Methods In this qualitative, observational cohort study, participants were recruited to partake in two rounds of interviews. During visit 1, a cognitive interview examined EoE-associated concepts and the appropriateness of the DSQ for assessing dysphagia. Participants completed the DSQ daily for 2 weeks, and DSQ scores were calculated. After 2 weeks, a second interview assessed the usability of the DSQ on the electronic device and the burden associated with completing it daily. Results Overall, 16 participants were included (aged 7–8 years: n = 8; aged 9–10 years: n = 8); most were male (75%) and white (81%), and the mean (standard deviation [SD]) age was 8.4 (1.3) years. The most commonly reported EoE-associated concept was ‘trouble with swallowing’ (63% [10/16]). Most participants reported that the questions were ‘easy to complete’ and ‘relevant to someone with EoE and dysphagia’. Overall, participants reported understanding the questions and associated responses; however, further probing demonstrated inconsistent comprehension. Key challenging concepts included ‘solid food’, ‘trouble swallowing’, ‘vomit’, and ‘relief’; some participants also reported difficulty differentiating between pain levels (31% [4/13]). Most caregivers reported that their child had experienced dysphagia (94% [15/16]); however, mean (SD) DSQ scores over the study period were low (7.3 [7.4]), suggesting infrequent and mild dysphagia, or a lack of comprehension of the questions. Most participants reported that completing the DSQ on the electronic device was easy (93% [14/15]) and they would be willing to complete it for longer than 2 weeks (73% [11/15]). Conclusions Difficulties with comprehension and comprehensiveness suggest that the DSQ may not be sufficiently comprehensive for use in all patients in this population, and wording/phrasing changes are required before use in a clinical trial setting. |
| first_indexed | 2024-03-11T12:41:11Z |
| format | Article |
| id | doaj.art-e3b91581a62d403485c5cdf9b76d5429 |
| institution | Directory Open Access Journal |
| issn | 2509-8020 |
| language | English |
| last_indexed | 2024-03-11T12:41:11Z |
| publishDate | 2023-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Patient-Reported Outcomes |
| spelling | doaj.art-e3b91581a62d403485c5cdf9b76d54292023-11-05T12:19:47ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202023-10-017111410.1186/s41687-023-00646-zQualitative assessment of the suitability of the Dysphagia Symptom Questionnaire to monitor dysphagia in children aged 7–10 years with eosinophilic esophagitisRobin M. Pokrzywinski0Bridgett Goodwin1Evan S. Dellon2Ellyn Kodroff3Anne Brooks4Adam Bailey5James Williams6Nirav K. Desai7EvideraTakeda Development Center Americas, Inc.Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel HillCampaign Urging Research for Eosinophilic DiseaseEvideraEvideraTakeda Development Center Americas, Inc.Takeda Development Center Americas, Inc.Abstract Background The Dysphagia Symptom Questionnaire (DSQ) is a patient-reported outcome measure that assesses the frequency and severity of dysphagia in patients with eosinophilic esophagitis (EoE); however, it has only been validated for use in patients with EoE aged 11–40 years. This study examined the content validity of the DSQ and its usability on an electronic handheld device in children aged 7–10 years with EoE. Methods In this qualitative, observational cohort study, participants were recruited to partake in two rounds of interviews. During visit 1, a cognitive interview examined EoE-associated concepts and the appropriateness of the DSQ for assessing dysphagia. Participants completed the DSQ daily for 2 weeks, and DSQ scores were calculated. After 2 weeks, a second interview assessed the usability of the DSQ on the electronic device and the burden associated with completing it daily. Results Overall, 16 participants were included (aged 7–8 years: n = 8; aged 9–10 years: n = 8); most were male (75%) and white (81%), and the mean (standard deviation [SD]) age was 8.4 (1.3) years. The most commonly reported EoE-associated concept was ‘trouble with swallowing’ (63% [10/16]). Most participants reported that the questions were ‘easy to complete’ and ‘relevant to someone with EoE and dysphagia’. Overall, participants reported understanding the questions and associated responses; however, further probing demonstrated inconsistent comprehension. Key challenging concepts included ‘solid food’, ‘trouble swallowing’, ‘vomit’, and ‘relief’; some participants also reported difficulty differentiating between pain levels (31% [4/13]). Most caregivers reported that their child had experienced dysphagia (94% [15/16]); however, mean (SD) DSQ scores over the study period were low (7.3 [7.4]), suggesting infrequent and mild dysphagia, or a lack of comprehension of the questions. Most participants reported that completing the DSQ on the electronic device was easy (93% [14/15]) and they would be willing to complete it for longer than 2 weeks (73% [11/15]). Conclusions Difficulties with comprehension and comprehensiveness suggest that the DSQ may not be sufficiently comprehensive for use in all patients in this population, and wording/phrasing changes are required before use in a clinical trial setting.https://doi.org/10.1186/s41687-023-00646-zDysphagiaQualitative assessmentPatient-reported outcomesEsophageal eosinophiliaPediatricElectronic device |
| spellingShingle | Robin M. Pokrzywinski Bridgett Goodwin Evan S. Dellon Ellyn Kodroff Anne Brooks Adam Bailey James Williams Nirav K. Desai Qualitative assessment of the suitability of the Dysphagia Symptom Questionnaire to monitor dysphagia in children aged 7–10 years with eosinophilic esophagitis Journal of Patient-Reported Outcomes Dysphagia Qualitative assessment Patient-reported outcomes Esophageal eosinophilia Pediatric Electronic device |
| title | Qualitative assessment of the suitability of the Dysphagia Symptom Questionnaire to monitor dysphagia in children aged 7–10 years with eosinophilic esophagitis |
| title_full | Qualitative assessment of the suitability of the Dysphagia Symptom Questionnaire to monitor dysphagia in children aged 7–10 years with eosinophilic esophagitis |
| title_fullStr | Qualitative assessment of the suitability of the Dysphagia Symptom Questionnaire to monitor dysphagia in children aged 7–10 years with eosinophilic esophagitis |
| title_full_unstemmed | Qualitative assessment of the suitability of the Dysphagia Symptom Questionnaire to monitor dysphagia in children aged 7–10 years with eosinophilic esophagitis |
| title_short | Qualitative assessment of the suitability of the Dysphagia Symptom Questionnaire to monitor dysphagia in children aged 7–10 years with eosinophilic esophagitis |
| title_sort | qualitative assessment of the suitability of the dysphagia symptom questionnaire to monitor dysphagia in children aged 7 10 years with eosinophilic esophagitis |
| topic | Dysphagia Qualitative assessment Patient-reported outcomes Esophageal eosinophilia Pediatric Electronic device |
| url | https://doi.org/10.1186/s41687-023-00646-z |
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