Identifying dysphagia in the intensive care unit: Validation of the Swedish version of the Gugging swallowing screen—Intensive care unit
Authors' conclusion
This study indicates that the Swedish GUSS-IVA is a valid and reliable screen to identify dysphagic ICU patients.
Study context
- Population
- Adult intensive care units (ICU) patients with endotracheal intubation >48 h, once extubated, 3 hospitals in Sweden51 underwent Flexible Endoscopic Evaluation of Swallowing (FEES)
- Participants
- 56 patients
- Comparison
- GUSS-IVA screen by ICU nursing staff vs FEES
- GUSS-IVAn = 56
- Outcome
- Sensitivity, specificity and AUC of GUSS-IVA vs FEES for dysphagia
Methodological detailsprospective, multicentre, blinded FEES assessors
- Prospective
- Multicentre
- Blinded FEES assessors
Performance
As reported in the abstract
Diagnostic accuracy of GUSS-IVA vs FEES
| Test or model | Sensitivity | Specificity | AUC | PPV |
|---|---|---|---|---|
| GUSS-IVA | 81% | 89% | 0.85 (95% CI: 0.71-0.95) | 97% |
GUSS-IVA
Sensitivity81%
Specificity89%
AUC0.85 (95% CI: 0.71-0.95)
PPV97%
Further findings
Dysphagia identified
- Dysphagia identified: FEES: 16 (31.4%) aspirating
Convergent validity of GUSS-IVA
- Dysphagia Outcome Severity Scale (ɸ), p < .001
- 0.57
- Functional Oral Intake Scale (ɸ), p < .001
- 0.52
- Penetration-Aspiration Scale (ɸ), p = .033
- 0.30
Inter-rater reliability (moderate agreement)
- Cohen's kappa κ, p = .006
- 0.501
- 29/56 screened a second time within 2 h
Original publication
Identifying dysphagia in the intensive care unit: Validation of the Swedish version of the Gugging swallowing screen—Intensive care unit. Acta Anaesthesiol Scand. Published 27 March 2025. doi:10.
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