Validity and Reliability of the MD Anderson Dysphagia Inventory in Turkish Patients with Neurological Disease

Introduction:Dysphagia is a prevalent symptom of variousneurological diseases and is associated with decreasedquality of life. The M.D. Anderson Dysphagia Inventory(MDADI) is globally utilizedtool to assess the impact ofdysphagia on quality of life. However, a Turkish version ofthe scale is not yet available. This study aimed to translate,culturally adapt, and evaluate the validity and reliability ofthe Turkish version of the MDADI.Methods:One hundredtwenty-four patients who were diagnosed with definiteneurological disease completed the study. The cross-cultural adaptation and translation process of the MDA-DI adhered to the World Health Organization's guidelinesusing the forward-backward translation method. Thefeasibility and thefloor and ceiling effects were evaluated.Cronbach's alpha was used to assess internal consistency.The Bland and Altman method and interclass correlationcoefficient (ICC) were used to evaluate test-retest reli-ability. Absolute reliability was determined using thestandard error of the measurement (SEM) and minimal detectable change (MDC). Construct validity was assessedusing Pearson's correlation coefficient between theMDADI and the Turkish Swallowing Quality of Life(T-SWAL-QOL) questionnaire.Results:Our study had afeasibility rate of 100%. Nofloor or ceiling effects weredetermined for any subscale or composite scores of theT-MDADI. The T-MDADI demonstrated excellent reliability,with Cronbach'salphacoefficients ranging from 0.89 to0.96 and ICC values from 0.81 to 0.95, confirming stronginternal consistency and test-retest reliability. Measure-ment precision was supported by a SEM of 3.96 and anMDC of 10.97 for the composite score. In terms of validity,significant correlations were observed between T-MDADIsubdomains and T-SWAL-QOL subdomains (r= 0.61-0.80for 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 convergentvalidity.Conclusion:The T-MDADI demonstrates validityand reliability as a questionnaire for assessing dysphagia-related quality of life in Turkish patients with neurologicaldiseases