Objective: To provide the psychometric validation of the French MDT-PD in the Luxembourgish multilingual population.

Background: The MDT-PD, developed and validated in German [1], is a highly sensitive and specific self-reported screening questionnaire to detect early oropharyngeal symptoms and aspiration risk in patients with idiopathic Parkinson’s disease (IPD).

Methods: Patients with parkinsonism, speaking fluently French and German, and without severe cognitive impairment (MoCA <17) were recruited in the context of HELP-PD, an observational non-interventional longitudinal cohort study. They performed the MDT-PD twice in French and once in German with 5-7 days intervals. Patients with a score ≥3.65 are undergoing a clinical examination and a flexible endoscopic evaluation of swallowing (FEES). Sample size calculation [2] estimated a minimum of 40 patients. The evaluation of the agreement between both tests will be performed with a Kappa test.

Results: Concerning test-retest reliability, 42 subjects were included in the validation study and 39 completed the French questionnaire twice, showing similar overall-scores in the two tests (3.6±2.3 vs 3.7±2.3). Compared one by one, the items showed no significant divergences (Kappa >0.3). Concerning language reliability, 35 subjects who completed the questionnaire once in German and once in French, obtained similar overall scores in both versions (3.7±2.3 vs 3.7±2.0), and showed no significant differences when comparing the items-responses one by one (Kappa >0.6). Cronbach’s alpha value was 0.84 in the French and 0.86 in the German version, showing a good internal consistency. The distribution of MDT-PD scores was similar for the different H&Y stages (range=3.1-5.8, median=3.4). A positive score for dysphagia (>3.65) was found in 19 patients (45%), and interestingly, 14 of these patients were at a mild disease stage (H&Y <2.5).

Conclusions: The results provide a validated French MDT-PD, what makes a non-invasive tool for early detection and implementation of novel prevention strategies, accessible to the French population. As dysphagia is expected only at more advanced disease stages, the number of positive patients at a mild disease stage is unexpected, supporting the hypothesis of dysphagia as an early symptom in PD. This will be addressed by the investigation of the sensitivity of this version, where all the positive patients are undergoing a continuative diagnostics with FEES.

References: 1. Simons JA, Fietzek UM, Waldmann A, Warnecke T, Schuster T, Ceballos-Baumann AO (2014) Development and validation of a new screening questionnaire for dysphagia in early stages of Parkinson’s disease. Parkinsonism Relat Disord 20: 992-998. 2. Hong H, Choi Y, Hahn S, Park SK, Park BJ (2014) Nomogram for sample size calculation on a straightforward basis for the kappa statistic. Ann Epidemiol 24: 673-680.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/validation-of-the-french-version-of-the-munich-dysphagia-test-parkinsons-disease-mdt-pd-in-a-multilingual-population-of-the-luxembourg-parkinsons-study-help-pd/