Assessing Dysphagia in Head and Neck Cancer Patients: Validation and Cultural Adaptation of the Thai M.D. Anderson Dysphagia Inventory (TH-MDADI):

Warut  Pongsapich; Narin Ratanaprasert; Prachya  Maneeprasopchoke; Paveena  Pithuksurachai; Cheerasook  Chongkolwatana; Chanticha  Chotigavanich; Paiboon  Sureepong; Sunun  Ongard; Phawin Keskool

doi:10.33192/smj.v77i4.272679

Authors

Warut Pongsapich Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Narin Ratanaprasert Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Prachya Maneeprasopchoke Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Paveena Pithuksurachai Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Cheerasook Chongkolwatana Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Chanticha Chotigavanich Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Paiboon Sureepong Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Sunun Ongard Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Phawin Keskool Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

DOI:

https://doi.org/10.33192/smj.v77i4.272679

Keywords:

Head and neck cancer, MDADI, SF-36, health-related quality of life

Abstract

Objective: The validation study of the Thai version of the M.D. Anderson Dysphagia Inventory (TH-MDADI) addresses a critical gap in head and neck cancer (HNC) care in Thailand. At leading institutions like Siriraj Hospital, patient-reported outcomes have been historically neglected, with care primarily focusing on routine medical services. This study aimed to validate the TH-MDADI to enhance dysphagia assessment and promote patient centered care.

Materials and Methods: In this longitudinal prospective study, 66 HNC patients completed the TH-MDADI and SF-36 at baseline, pre-treatment, and post-treatment at Siriraj Hospital. Psychometric properties were evaluated, including internal consistency (Cronbach’s α), test-retest reliability (intraclass correlation coefficient, ICC), convergent and discriminant validity (correlations with SF-36 domains), and responsiveness (standardized response mean, SRM).

Results: The TH-MDADI demonstrated excellent internal consistency (Cronbach’s α = 0.93) and test-retest reliability (ICC = 0.92, 95% CI: 0.88–0.96). Strong correlations with related SF-36 domains (r = 0.64-0.74, p < 0.001) established convergent validity, while weak correlations with unrelated domains confirmed discriminant validity. High responsiveness to change post-treatment was observed, particularly in the Global (SRM = 3.83) and Emotional (SRM = 3.17) subscales.

Conclusion: The TH-MDADI demonstrates robust psychometric properties, establishing its value as a reliable tool for assessing dysphagia-related quality of life in Thai HNC patients. This validation represents a significant advancement in Thai cancer care, addressing the historical neglect of patient-reported outcomes. By providing clinicians with a validated assessment instrument, this study promotes a more systematic, patient-centered approach to HNC treatment in Thailand.

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