Modification of the Gugging Swallowing Screen and its reliability and validity testing

YIN Junlian; BAI Huihua; ZHU Xiaojuan; LIU Qiuhong; HE Lei

doi:10.12102/j.issn.1009-6493.2025.10.014

Abstract：Objective:To modify the Gugging Swallowing Screen(GUSS)and test its reliability and validity.Methods:Based on the theory of food rheology for quantifying food consistency,the modified GUSS was developed through Delphi expert consultation and preliminary survey.A total of 167 patients with ischemic stroke in the department of neurosurgery at The First People's Hospital of Changzhou in Jiangsu province were selected by convenience sampling from July 1 to October 31,2023 to evaluate the reliability and validity of the scale.Results:Two rounds of expert consultation were conducted,the questionnaire recovery both rates were 100.00%.The expert authority coefficients were 0.795 and 0.875,respectively.The Kendall's W were 0.257 and 0.234(both P<0.05).The Cronbach's α coefficient of the scale was 0.809.The inter-rater reliability was 0.931(P<0.001).The inter-rater agreement Kappa value was 0.703(P<0.001).The test-retest reliability was 0.855.The correlation coefficients among the scores of each item of the scale ranged from 0.465 to 0.882(all P<0.01).The correlation coefficients between the scores of each item and the total score of the scale ranged from 0.625 to 0.961(all P<0.01).The correlation coefficient between the Water Swallowing Test and the scale score was 0.836(P<0.001).One common factor was extracted,with cumulative variance contribution rate of 77.465%.The area under the curve of receiver operator characteristic was 0.993(95%CI 0.985-1.000).When using 21.5 points as the cutoff value for swallowing dysfunction,the sensitivity of the scale was 97%,and the specificity was 93%.Conclusions:The modified GUSS is scientifically robust and has good reliability and validity.It can be used for assessing the severity of swallowing dysfunction and the safe bolus volume.