{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:19:34Z","timestamp":1787656774027,"version":"build-2736575974"},"reference-count":43,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine clinically useful MD Anderson Dysphagia Inventory (MDADI) thresholds associated with Videofluoroscopic swallow study (VFSS)\u2010graded swallowing impairment in head and neck cancer (HNC) patients and to explore whether a reduced\u2010item MDADI could preserve discrimination while minimizing patient burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cross\u2010sectional study analyzed HNC patients from a prospectively maintained dysphagia surveillance program who completed the MDADI within 120\u2009days of VFSS. Associations between MDADI and VFSS metrics were assessed using Spearman and point\u2010biserial correlations. Swallowing impairment was defined using Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) and Penetration\u2013Aspiration Scale (PAS) with clinically relevant dichotomization. Optimal MDADI composite score thresholds were derived using Youden's\n                      <jats:italic>J<\/jats:italic>\n                      statistic, and exploratory item reduction investigated the ability of a concise subset to preserve discrimination of clinically significant impairment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 208 patients contributed 470 MDADI\u2013VFSS observations for PAS and 443 for DIGEST (mean follow\u2010up 3.7\u2009years and MDADI\u2013VFSS interval 56\u2009\u00b1\u200935.9\u2009days). MDADI composite scores showed moderately strong and moderate inverse correlations with DIGEST (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.63,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and PAS (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.50,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), respectively, with good discrimination across both outcome definitions (AUC 0.78\u20130.88). Optimal MDADI thresholds ranged from 74 to 78 with ~74 best identifying DIGEST\u2009\u2265\u20092. A four\u2010item MDADI short form (F3, E3, E4, and P6) showed strong agreement with Composite score (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.96), with good discrimination of DIGEST\u2010defined impairment (AUC\u2009=\u20090.85).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MDADI scores correlate with VFSS\u2010graded impairment in HNC patients. A composite threshold near 74 may serve as a clinically useful screening parameter for identifying patients requiring swallowing evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70835","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:27:44Z","timestamp":1787653664000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>MDADI<\/scp>\n                    as a Screening Tool for\n                    <scp>VFSS<\/scp>\n                    \u2010Graded Swallowing Impairment in Head and Neck Cancer Patients"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3840-1243","authenticated-orcid":false,"given":"Zachary G.","family":"Brumm","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, UCSF Voice and Swallowing Center University of California, San Francisco  San Francisco California USA"},{"name":"San Francisco School of Medicine University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A.","family":"Anyimadu","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Kohli","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, UCSF Voice and Swallowing Center University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Silver","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, UCSF Voice and Swallowing Center University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8953-8373","authenticated-orcid":false,"given":"Beatrice","family":"Manduchi","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3710-5706","authenticated-orcid":false,"given":"Katherine","family":"Hutcheson","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8060-2954","authenticated-orcid":false,"given":"Arushi","family":"Gulati","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, UCSF Voice and Swallowing Center University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Elisabeta","family":"Marai","sequence":"additional","affiliation":[{"name":"Department of Computer Science University of Illinois Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7070-1342","authenticated-orcid":false,"given":"Tyler W.","family":"Crosby","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, UCSF Voice and Swallowing Center University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1571-1086","authenticated-orcid":false,"given":"Clark A.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, UCSF Voice and Swallowing Center University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3095-8290","authenticated-orcid":false,"given":"VyVy N.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, UCSF Voice and Swallowing Center University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guadalupe","family":"Canahuate","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1758-3276","authenticated-orcid":false,"given":"Yue","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, UCSF Voice and Swallowing Center University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25880"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25412"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010016\u20102990\u2010x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.70085"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.70065"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2014.08.009"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941011900605"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21700"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1714562"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.06.017"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.302"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.28166"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30355"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26119"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25778"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2016.06.010"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010021\u201010281\u20109"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010024\u201011241\u20101"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30283"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00417897"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34079"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2015.10.015"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24344"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30120753"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010021\u201010364\u20107"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030692"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27610"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1590\/2317\u20101782\/20172015175"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2018.06.014"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010022\u201010434\u20104"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31957"},{"issue":"7","key":"e_1_2_10_33_1","first-page":"870","article-title":"The Development and Validation of a Dysphagia\u2010Specific Quality\u2010Of\u2010Life Questionnaire for Patients With Head and Neck Cancer: The M. D. Anderson Dysphagia Inventory","volume":"127","author":"Chen A. Y.","year":"2001","journal-title":"Archives of Otolaryngology\u2014Head & Neck Surgery"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010016\u20109758\u2010y"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010019\u201010064\u20103"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2018.06.013"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.2725"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2026.111365"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010200409000\u201000009"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28312"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940811701210"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31900"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70835","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70835","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:27:45Z","timestamp":1787653665000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":43,"alternative-id":["10.1002\/lary.70835"],"URL":"https:\/\/doi.org\/10.1002\/lary.70835","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"assertion":[{"value":"2026-04-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"lary.70835"}}