摘要目的 探讨标准吞咽功能评定量表(SSA)的信度、效度、敏感度、特异度、阳性预测值和阴性预测值,为临床应用提供客观依据.方法 67例脑卒中后吞咽障碍患者,3d内应用SSA评定2次,并进行电视X线透视吞咽功能检查(VFSS).对2次SSA结果作相关性分析来测试其重复测量信度,将SSA与VFSS结果作相关性检验来验证SSA的效度;以VFSS为金标准,分析SSA的敏感度和特异度.结果 SSA各项内容2次重复测试结果高度相关,其组内相关系数ICC=0.85(P<0.01),组间相关系数ICC=0.82(P<0.01);SSA总分和VFSS吞咽困难程度评分总分高度相关,r=-0.86(P<0.01);以VFSS为金标准,SSA的敏感度为77.8%,特异度为68.1%,阳性预测值为48.3%,阴性预测值为88.9%.结论 SSA具有良好的信度和效度,较高的敏感度和特异度,使用方便,适合临床应用于脑卒中患者的吞咽功能评定.

abstractsObjective To study the reliability, validity, sensitivity, specificity and predictive value of the Standardized Swallowing Assessment (SSA) in assessing swallowing function. Methods Sixty-seven stroke patients with dysphagia participated in the study. They were assessed twice with the SSA within 3 days. In addition, the patients' swallowing was also assessed using videofluoroscopy. Results There was high correlation in all items of the SSA between the two separate assessment sessions. The intraclass correlation coefficient was 0.85 for intrarater re- liability and 0.82 for interrater reliability. The SSA and videoflouroscopy results were highly correlated in terms of their total scores (r = -0.86,P≤0.01). Using the videoflouroscopy result as the standard, the sensitivity and spe- cificity of the SSA were 77.8% and 68.1% , respectively. At the same time, the positive and negative predictive val- ues were 48.3% and 88.9% , respectively. Conclusions The SSA has satisfactory reliability and validity, and higher sensitivity and specificity than videoflouroscopy. It is recommended for assessing swallowing with stroke pa- tients.