Jaw-Opening Force Test to Screen for Dysphagia: Preliminary Results

Objective: To assess the jaw-opening force test (JOFT) for dysphagia screening. Design: Criterion standard. Setting: University dental hospital. Participants: Patients complaining of dysphagia (N=95) and with symptoms of dysphagia with chronic underlying causes (mean age +/- SD, 79.3 +/- 9.61y; range, 50-94y; men: n=49; mean age +/- SD, 77.03 +/- 9.81y; range, 50-94y; women: n=46; mean age +/- SD, 75.42 +/- 9.73y; range, 51-93y) admitted for treatment between May 2011 and December 2012 were included. Interventions: None. Main Outcome Measures: All patients were administered the JOFT and underwent fiberoptic endoscopic evaluation of swallowing (FEES). The mean jaw-opening strength was compared with aspiration (ASP) and pharyngeal residue observations of the FEES, which was used as the criterion standard. Results: A receiver operating characteristic (ROC) curve analysis was performed. Forces of <= 3.2kg for men and <= 4kg for women were appropriate cutoff values for predicting ASP with a sensitivity and specificity of .57 and .79 for men and .93 and .52 for women, respectively. Based on the ROC analyses for predicting pharyngeal residue, forces of <= 5.3kg in men and <= 3.9kg in women were appropriate cutoff values, with a sensitivity and specificity of .80 and .88 for men and .83 and .81 for women, respectively. Conclusions: The JOFT could be a useful screening tool for predicting pharyngeal residue and could provide useful information to aid in the referral of patients for further diagnostic imaging testing. However, given its low sensitivity to ASP the JOFT should be paired with other screening tests that predict ASP. (C) 2014 by the American Congress of Rehabilitation Medicine