The Bostwick consistometer and the International Dysphagia Diet Standardization Initiative (IDDSI) Flow Test are both proposed methods to measure and categorize thickened liquids for dysphagia management. The objectives were to: (a) compare the Bostwick consistometer reference values used in clinical settings and the IDDSI reference values of thickened liquids suggested for nutrition care plans in the management of dysphagia when measuring commercially available preprepared thickened liquids; (b) explore the relationship between the two methods; (c) assess the interchangeability; (d) document the intra‐rater reliability. Preprepared thickened liquids (n = 32) were measured twice with the Bostwick consistometer and 3 times with the IDDSI Flow Test, using a rigorous methodology. A registered dietitian nutritionist and a registered nutrition and dietetic technician performed the measurements. The Pearson's correlation coefficient was calculated to explore the relationship between the two methods. Using a linear regression equation, back‐calculations of the IDDSI Flow Test values were done, based on the experimental Bostwick results. Interchangeability was assessed by documenting the level of agreement between the results with a Bland and Altman graphical analysis. Intraclass correlation coefficients calculation and a Bland and Altman graphical analysis were performed to assess reliability. The strong correlation (r = −.93, p < .001) between the IDDSI Flow Test and the Bostwick consistometer measurements suggests that they measure flow rate in a similar manner, but not exactly the same, as confirmed with the Bland and Altman graphical analysis. Thus, they produced results that are not interchangeable. However, both tests show excellent intra‐rater reliability (ICC ≥ 0.99) when using a rigorous methodology. Practical applications Thickened liquids are used to manage oropharyngeal dysphagia. Clinicians need to provide quality assurance/quality control (QA/QC) support in the selection or production of thickened liquids as well as staff training or patient education regarding these products. Methods and classification have been proposed to measure and categorize thickened liquids for dysphagia management, such as the line spread test, the Bostwick consistometer method, and the IDDSI Flow Test. Although empirical, these methods are more accessible to clinicians than viscometer or rheometer assessments. Clinicians need to understand the limitations of these techniques as neither appear to capture the full extent of consistency for potential beverages available on the market or produced in‐house. In this article, we compare the Bostwick consistometer and the IDDSI Flow Test methods and classifications and propose a standard operating procedure in order to maximize the quality of results. We point out the large variations in consistency levels of commercial preprepared thickened liquids in light of the absence of evidence of clinical outcomes associated with either proposed methods or consistency classifications.

The Edinburgh Feeding Evaluation in Dementia (EdFED) Scale was designed to identify feeding difficulties for people with moderate to severe dementia. Its Canadian-French cross-cultural adaptation was carried out, as part of an experimental study, whose secondary objective was to document its construct validity. A back-translation method was followed. The EdFED-f was used during a meal with 26 elderly residents who had cognitive disorders. There was a significant correlation between EdFED-f scores and energy intakes calculated using a visual estimation of plate wash method (r=-0,50, p=0,009). EdFED-f scores also showed a significant difference according to the percentage of food consumed at meals (p=0,015). These results support the validity of the EdFED-f to assess feeding difficulties among elderly French-speaking Canadians living in residential and long-term care centers.

To delay impacts of aging, optimal nutritional status is essential. Several factors can reduce food intake, such as isolation, income, and cognitive/physical decline. Additionally, chewing and swallowing difficulties, or dysphagia, often disrupt the ability to consume life-long favorite dishes. Food and liquids could require modification of texture or consistency to ensure a comfortable or safe swallow. The food industry, foodservices facilities, and caregivers need quality control benchmarks to provide adequate nourishment and meet these new feeding challenges. The International Dysphagia Diet Standardisation Initiative (IDDSI) is proposing the IDDSI framework and testing methods to describe food used in nutritional care plans to circumvent dysphagia and improve communication among caregivers. This systematic review assesses the validity and reliability of the IDDSI testing methods using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN). Two publications presented content validity whereas 19 publications looked at construct validity or reliability for the IDDSI testing methods. One study was conducted in older adults presenting dysphagia. This review concludes that there is insufficient evidence to recommend the IDDSI testing methods. Further research, conducted with robust methodological design and reporting, is needed to develop and assess nutritious adapted food for frail older populations.

Introduction: There is no patient‐reported outcome (PRO) questionnaire specifically designed to assess oropharyngeal dysphagia in oculopharyngeal muscular dystrophy (OPMD). To select a suitable questionnaire, content validity of the existing questionnaires must be assessed. This study sought (1) to identify dysphagia‐related symptoms in OPMD and (2) to assess content validity of currently available PRO for the assessment of dysphagia severity in OPMD. Methods: A two‐step literature review was conducted of dysphagia‐related symptom identification and oropharyngeal dysphagia‐related PRO. Symptoms were validated with an expert panel by using a Delphi survey. Content validity of PRO questionnaires was documented through content analysis. Results: Ten PRO questionnaires were identified. None of the questionnaires cover the entire symptom spectrum in OPMD and thus lack content validity. Discussion: The development and validation of a new PRO questionnaire to assess dysphagia in OPMD is required to establish the importance of symptomatic relief from new treatments. Muscle Nerve 59:445–450, 2019

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Introduction There is currently little evidence regarding oculopharyngeal muscular dystrophy (OPMD) disease burden reported by patients. In this study we aim to elicit direct patient input regarding OPMD disease burden. Methods We conducted semistructured interviews with 25 participants with genetically confirmed OPMD and a wide range of disease duration (15 ± 8 years). Using the Framework Technique, themes and categories were then extracted. Results Analyses revealed 7 themes (physical impact, mental impact, social impact, perception of progression, treatment perceptions, coping strategies, and access to disease information), encompassing 27 categories of OPMD disease burden. The most frequent categories were related to dysphagia, coping strategies for dysphagia, and impaired mobility. Discussion This study demonstrates the importance of considering, when providing clinical care, the broad range of coping strategies patients use to deal with OPMD symptoms, especially dysphagia, to properly assess limitations and monitor real disease progression.

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