{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T17:14:06Z","timestamp":1794244446643,"version":"4.9.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007195","name":"Universit\u00e0 degli Studi di Napoli Federico II","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007195","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate reliability of the Dysphagia Outcome and Severity Scale (DOSS) in Amyotrophic Lateral Sclerosis (ALS) patients, and to assess diagnostic accuracy of selected non-instrumental measures in defining swallowing safety in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One hundred and thirteen consecutive ALS patients underwent comprehensive dysphagia evaluation with fiberoptic endoscopic evaluation of swallowing (FEES) and were classified according to DOSS. Safe and unsafe swallowing were defined by DOSS levels 7\u20136 and 5\u20131, respectively. Patient-reported measures included ALS Functional Rating Scale-Revised swallow item (I-3) and Eating Assessment Tool-10 (EAT-10). Non-instrumental clinical measures were hyolaryngeal excursion, voluntary cough (VC), voice quality and reflexive cough\/throat clearing (VRC), and maximum phonation time (MPT). Inter- and intra-rater reliability were assessed using weighted Cohen\u2019s kappa and Fleiss\u2019 kappa coefficients. Non-instrumental measures diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-six of 113 patients (23%) exhibited an unsafe swallowing. Inter- and intra-rater agreement for DOSS classification was excellent across raters. EAT-10 and a composite clinical index derived from VC, VRC, and MPT showed the highest diagnostic accuracy with area under the curve values of 0.790 and 0.832, respectively. Other non-instrumental measures demonstrated lower discriminative performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The DOSS showed an excellent reliability when applied to FEES in patients with ALS, supporting its use as a functional classification tool with direct nutritional and management implications. Non-instrumental measures should be interpreted with caution and confined to a triage role rather than diagnostic decision-making, particularly in light of the rapid progression of dysphagia in ALS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10072-026-09076-3","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T01:50:40Z","timestamp":1778118640000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Dysphagia Outcome and Severity Scale (DOSS) and non-instrumental swallowing measures in amyotrophic lateral sclerosis"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8253-7220","authenticated-orcid":false,"given":"Sergio","family":"Motta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Quaremba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Aruta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Allosso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianmaria","family":"Senerchia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina Virginia","family":"Iuzzolino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Dubbioso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"9076_CR1","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1007\/s10072-024-07760-w","volume":"46","author":"R Soliman","year":"2025","unstructured":"Soliman R, Onbool E, Omran K, Fahmy N (2025) Clinical and epidemiological characteristics of amyotrophic lateral sclerosis in an Egyptian cohort. Neurol Sci 46:1225\u20131236. https:\/\/doi.org\/10.1007\/s10072-024-07760-w","journal-title":"Neurol Sci"},{"key":"9076_CR2","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1002\/mus.27361","volume":"64","author":"J Lee","year":"2021","unstructured":"Lee J, Madhavan A, Krajewski E, Lingenfelter S (2021) Assessment of dysarthria and dysphagia in patients with amyotrophic lateral sclerosis: Review of the current evidence. Muscle Nerve 64:520\u2013531. https:\/\/doi.org\/10.1002\/mus.27361","journal-title":"Muscle Nerve"},{"key":"9076_CR3","doi-asserted-by":"publisher","first-page":"2727","DOI":"10.1007\/s00405-021-07161-1","volume":"279","author":"A Schindler","year":"2022","unstructured":"Schindler A, Baijens LWJ, Geneid A, Pizzorni N (2022) Phoniatricians and otorhinolaryngologists approaching oropharyngeal dysphagia: an update on FEES. Eur Arch Otorhinolaryngol 279:2727\u20132742. https:\/\/doi.org\/10.1007\/s00405-021-07161-1","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"9076_CR4","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/BF00417897","volume":"11","author":"JC Rosenbek","year":"1996","unstructured":"Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL (1996) A penetration-aspiration scale. Dysphagia 11:93\u201398. https:\/\/doi.org\/10.1007\/BF00417897","journal-title":"Dysphagia"},{"key":"9076_CR5","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/PL00009595","volume":"14","author":"KH O\u2019Neil","year":"1999","unstructured":"O\u2019Neil KH, Purdy M, Falk J, Gallo L (1999) The Dysphagia Outcome and Severity Scale. Dysphagia 14:139\u2013145. https:\/\/doi.org\/10.1007\/PL00009595","journal-title":"Dysphagia"},{"key":"9076_CR6","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1186\/s13104-023-06637-z","volume":"16","author":"K Movander","year":"2023","unstructured":"Movander K, Larsson Palmquist T, H\u00e4gglund P, Bergstr\u00f6m L (2023) Translation, and validation of Dysphagia Outcome and Severity Scale (DOSS): Swedish version. BMC Res Notes 16:369. https:\/\/doi.org\/10.1186\/s13104-023-06637-z","journal-title":"BMC Res Notes"},{"key":"9076_CR7","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1007\/s00455-024-10732-z","volume":"40","author":"J Fransson","year":"2025","unstructured":"Fransson J, Thor\u00e9n S, Selg J, Bergstr\u00f6m L, H\u00e4gglund P (2025) Validity and Reliability of Dysphagia Outcome Severity Scale (DOSS) When Used to Rate Flexible Endoscopic Evaluations of Swallowing (FEES). Dysphagia 40:343\u2013352. https:\/\/doi.org\/10.1007\/s00455-024-10732-z","journal-title":"Dysphagia"},{"key":"9076_CR8","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1007\/s00455-021-10283-7","volume":"37","author":"R Speyer","year":"2022","unstructured":"Speyer R, Cordier R, Farneti D, Nascimento W, Pilz W, Verin E, Walshe M, Woisard V (2022) White Paper by the European Society for Swallowing Disorders: Screening and Non-instrumental Assessment for Dysphagia in Adults. Dysphagia 37:333\u2013349. https:\/\/doi.org\/10.1007\/s00455-021-10283-7","journal-title":"Dysphagia"},{"key":"9076_CR9","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1056\/NEJMp1113631","volume":"366","author":"DB Reuben","year":"2012","unstructured":"Reuben DB, Tinetti ME (2012) Goal-oriented patient care-an alternative health outcomes paradigm. N Engl J Med 366:777\u2013779. https:\/\/doi.org\/10.1056\/NEJMp1113631","journal-title":"N Engl J Med"},{"key":"9076_CR10","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1080\/21678421.2023.2260832","volume":"25","author":"JM Shefner","year":"2024","unstructured":"Shefner JM, Bunte T, Kittle G, Genge A, van den Berg LH (2024) Harmonized standard operating procedures for administering the ALS functional rating scale-revised. Amyotroph Lateral Scler Frontotemporal Degener 25:26\u201333. https:\/\/doi.org\/10.1080\/21678421.2023.2260832","journal-title":"Amyotroph Lateral Scler Frontotemporal Degener"},{"key":"9076_CR11","doi-asserted-by":"publisher","first-page":"3919","DOI":"10.1007\/s10072-023-06918-2","volume":"44","author":"X Xia","year":"2023","unstructured":"Xia X, Zhang W, Guo J, Chang X, Zhao R, Wang J, Pang X, Zhang J (2023) Diagnostic utility of different dysphagia screening tools to detect dysphagia in individuals with amyotrophic lateral sclerosis. Neurol Sci 44:3919\u20133927. https:\/\/doi.org\/10.1007\/s10072-023-06918-2","journal-title":"Neurol Sci"},{"key":"9076_CR12","doi-asserted-by":"publisher","first-page":"e0236804","DOI":"10.1371\/journal.pone.0236804","volume":"15","author":"JL Chapin","year":"2020","unstructured":"Chapin JL, Gray LT, Vasilopoulos T, Anderson A, DiBiase L, York JD, Robison R, Wymer J, Plowman EK (2020) Diagnostic utility of the amyotrophic lateral sclerosis Functional Rating Scale-Revised to detect pharyngeal dysphagia in individuals with amyotrophic lateral sclerosis. PLoS ONE 15:e0236804. https:\/\/doi.org\/10.1371\/journal.pone.0236804","journal-title":"PLoS ONE"},{"key":"9076_CR13","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1177\/000348940811701210","volume":"117","author":"PC Belafsky","year":"2008","unstructured":"Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ (2008) Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol 117:919\u2013924. https:\/\/doi.org\/10.1177\/000348940811701210","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"9076_CR14","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1111\/nmo.12700","volume":"28","author":"EK Plowman","year":"2016","unstructured":"Plowman EK, Tabor LC, Robison R, Gaziano J, Dion C, Watts SA, Vu T, Gooch C (2016) Discriminant ability of the Eating Assessment Tool-10 to detect aspiration in individuals with amyotrophic lateral sclerosis. Neurogastroenterol Motil 28:85\u201390. https:\/\/doi.org\/10.1111\/nmo.12700","journal-title":"Neurogastroenterol Motil"},{"issue":"1","key":"9076_CR15","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/s40141-023-00396-5","volume":"11","author":"TH Kao","year":"2023","unstructured":"Kao TH, Perry BJ (2023) The Current State and Future Directions of Swallowing Care in Amyotrophic Lateral Sclerosis. Curr Phys Med Rehabil Rep 11(1):199\u2013211. https:\/\/doi.org\/10.1007\/s40141-023-00396-5","journal-title":"Curr Phys Med Rehabil Rep"},{"key":"9076_CR16","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1007\/s00455-013-9490-9","volume":"29","author":"B Kertscher","year":"2014","unstructured":"Kertscher B, Speyer R, Palmieri M, Plant C (2014) Bedside screening to detect oropharyngeal dysphagia in patients with neurological disorders: an updated systematic review. Dysphagia 29:204\u2013212. https:\/\/doi.org\/10.1007\/s00455-013-9490-9","journal-title":"Dysphagia"},{"key":"9076_CR17","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1093\/ageing\/27.2.99","volume":"27","author":"DG Smithard","year":"1998","unstructured":"Smithard DG, O\u2019Neill PA, Park C, England R, Renwick DS, Wyatt R, Morris J, Martin DF (1998) North West Dysphagia Group. Can bedside assessment reliably exclude aspiration following acute stroke? Age Ageing 27:99\u2013106. https:\/\/doi.org\/10.1093\/ageing\/27.2.99","journal-title":"Age Ageing"},{"key":"9076_CR18","doi-asserted-by":"publisher","first-page":"2948","DOI":"10.1161\/STROKEAHA.107.483933","volume":"38","author":"M Trapl","year":"2007","unstructured":"Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A, Brainin M (2007) Dysphagia bedside screening for acute-stroke patients: the Gugging Swallowing Screen. Stroke 38:2948\u20132952. https:\/\/doi.org\/10.1161\/STROKEAHA.107.483933","journal-title":"Stroke"},{"key":"9076_CR19","doi-asserted-by":"publisher","first-page":"3067","DOI":"10.1007\/s10072-020-04495-2","volume":"41","author":"M Panebianco","year":"2020","unstructured":"Panebianco M, Marchese-Ragona R, Masiero S, Restivo DA (2020) Dysphagia in neurological diseases: a literature review. Neurol Sci 41:3067\u20133073. https:\/\/doi.org\/10.1007\/s10072-020-04495-2","journal-title":"Neurol Sci"},{"key":"9076_CR20","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1097\/PHM.0b013e31824fa66a","volume":"91","author":"Z Zhou","year":"2012","unstructured":"Zhou Z, Vincent F, Salle JY, Antonini MT, Aliamus V, Daviet JC (2012) Acute stroke phase voluntary cough and correlation with maximum phonation time. Am J Phys Med Rehabil 91:494\u2013500. https:\/\/doi.org\/10.1097\/PHM.0b013e31824fa66a","journal-title":"Am J Phys Med Rehabil"},{"key":"9076_CR21","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/j.anl.2017.08.009","volume":"45","author":"S Yamaguchi","year":"2018","unstructured":"Yamaguchi S, Ishida M, Hidaka K, Gomi S, Takayama S, Sato K, Yoshioka Y, Wakayama N, Sekine K, Matsune S, Otsuka T, Okubo K (2018) Relationship between swallowing function and breathing\/phonation. Auris Nasus Larynx 45:533\u2013539. https:\/\/doi.org\/10.1016\/j.anl.2017.08.009","journal-title":"Auris Nasus Larynx"},{"key":"9076_CR22","doi-asserted-by":"publisher","first-page":"425","DOI":"10.5535\/arm.2018.42.3.425","volume":"42","author":"EJ Ko","year":"2018","unstructured":"Ko EJ, Chae M, Cho SR (2018) Relationship Between Swallowing Function and Maximum Phonation Time in Patients with Parkinsonism. Ann Rehabil Med 42:425\u2013432. https:\/\/doi.org\/10.5535\/arm.2018.42.3.425","journal-title":"Ann Rehabil Med"},{"key":"9076_CR23","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1007\/s00455-020-10198-9","volume":"36","author":"LC Velasco","year":"2021","unstructured":"Velasco LC, Imamura R, R\u00eago APV, Alves PR, da Silva Peixoto LP, de Oliveira Siqueira J (2021) Sensitivity and Specificity of Bedside Screening Tests for Detection of Aspiration in Patients Admitted to a Public Rehabilitation Hospital. Dysphagia 36:821\u2013830. https:\/\/doi.org\/10.1007\/s00455-020-10198-9","journal-title":"Dysphagia"},{"key":"9076_CR24","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.1044\/2022_JSLHR-22-00522","volume":"66","author":"L Tabor Gray","year":"2023","unstructured":"Tabor Gray L, Donohue C, Vasilopoulos T, Wymer JP, Plowman EK (2023) Maximum Phonation Time as a Surrogate Marker for Airway Clearance Physiologic Capacity and Pulmonary Function in Individuals with Amyotrophic Lateral Sclerosis. J Speech Lang Hear Res 66:1165\u20131172. https:\/\/doi.org\/10.1044\/2022_JSLHR-22-00522","journal-title":"J Speech Lang Hear Res"},{"key":"9076_CR25","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1007\/s00455-015-9631-4","volume":"30","author":"PD Neubauer","year":"2015","unstructured":"Neubauer PD, Rademaker AW, Leder SB (2015) The Yale Pharyngeal Residue Severity Rating Scale: An Anatomically Defined and Image-Based Tool. Dysphagia 30:521\u2013528. https:\/\/doi.org\/10.1007\/s00455-015-9631-4","journal-title":"Dysphagia"},{"key":"9076_CR26","volume-title":"Masa: The Mann Assessment of Swallowing Ability","author":"G Mann","year":"2002","unstructured":"Mann G (2002) Masa: The Mann Assessment of Swallowing Ability. Delmar Cengage Learning, New York"},{"key":"9076_CR27","doi-asserted-by":"publisher","unstructured":"Logemann JA (1998) The Evaluation and Treatment of Swallowing Disorders. 2nd Edition, Pro-Ed Inc., Austin. https:\/\/doi.org\/10.1097\/00020840-199812000-00008","DOI":"10.1097\/00020840-199812000-00008"},{"key":"9076_CR28","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1007\/s00455-017-9857-4","volume":"33","author":"A Zarkada","year":"2018","unstructured":"Zarkada A, Regan J (2018) Inter-rater Reliability of the Dysphagia Outcome and Severity Scale (DOSS): Effects of Clinical Experience, Audio-Recording and Training. Dysphagia 33:329\u2013336. https:\/\/doi.org\/10.1007\/s00455-017-9857-4","journal-title":"Dysphagia"},{"key":"9076_CR29","doi-asserted-by":"publisher","first-page":"94","DOI":"10.3389\/fneur.2017.00094","volume":"21","author":"E Onesti","year":"2017","unstructured":"Onesti E, Schettino I, Gori MC, Frasca V, Ceccanti M, Cambieri C, Ruoppolo G, Inghilleri M (2017) Dysphagia in Amyotrophic Lateral Sclerosis: Impact on Patient Behavior, Diet Adaptation, and Riluzole Management. Front Neurol 21:8:94. https:\/\/doi.org\/10.3389\/fneur.2017.00094","journal-title":"Front Neurol"},{"key":"9076_CR30","first-page":"105","volume":"34","author":"D Farneti","year":"2014","unstructured":"Farneti D, Fattori B, Nacci A, Mancini V, Simonelli M, Ruoppolo G et al (2014) The pooling-score (P-score): Inter- and Intra-Rater Reliability in Endoscopic Assessment of the Severity of Dysphagia. Acta Otorhinolaryngol Ital 34:105\u2013110","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"9076_CR31","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1007\/s00455-017-9809-z","volume":"32","author":"CM Steele","year":"2017","unstructured":"Steele CM, Grace-Martin K (2017) Reflections on Clinical and Statistical Use of the Penetration-Aspiration Scale. Dysphagia 32:601\u2013616. https:\/\/doi.org\/10.1007\/s00455-017-9809-z","journal-title":"Dysphagia"},{"key":"9076_CR32","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1007\/s00455-019-10064-3","volume":"35","author":"JC Borders","year":"2020","unstructured":"Borders JC, Brates D (2020) Use of the Penetration-Aspiration Scale in Dysphagia Research: A Systematic Review. Dysphagia 35:583\u2013597. https:\/\/doi.org\/10.1007\/s00455-019-10064-3","journal-title":"Dysphagia"},{"key":"9076_CR33","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1007\/s11136-018-1798-3","volume":"27","author":"CAC Prinsen","year":"2018","unstructured":"Prinsen CAC, Mokkink LB, Bouter LM, Alonso J, Patrick DL, de Vet HCW, Terwee CB (2018) COSMIN guideline for systematic reviews of patient-reported outcome measures. Qual Life Res 27:1147\u20131157. https:\/\/doi.org\/10.1007\/s11136-018-1798-3","journal-title":"Qual Life Res"},{"key":"9076_CR34","doi-asserted-by":"publisher","first-page":"CD012679","DOI":"10.1002\/14651858.CD012679.pub2","volume":"10","author":"E Boaden","year":"2021","unstructured":"Boaden E, Burnell J, Hives L, Dey P, Clegg A, Lyons MW, Lightbody CE, Hurley MA, Roddam H, McInnes E, Alexandrov A, Watkins CL (2021) Screening for aspiration risk associated with dysphagia in acute stroke. Cochrane Database Syst Rev 10:CD012679. https:\/\/doi.org\/10.1002\/14651858.CD012679.pub2","journal-title":"Cochrane Database Syst Rev"},{"key":"9076_CR35","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1007\/s004550010005","volume":"15","author":"T Warms","year":"2000","unstructured":"Warms T, Richards J (2000) Wet Voice as a predictor of penetration and aspiration in oropharyngeal dysphagia. Dysphagia 15:84\u201388. https:\/\/doi.org\/10.1007\/s004550010005","journal-title":"Dysphagia"},{"key":"9076_CR36","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1007\/s00455-015-9687-1","volume":"31","author":"EK Plowman","year":"2016","unstructured":"Plowman EK, Watts SA, Robison R, Tabor L, Dion C, Gaziano J, Vu T, Gooch C (2016) Voluntary Cough Airflow Differentiates Safe Versus Unsafe Swallowing in Amyotrophic Lateral Sclerosis. Dysphagia 31:383\u2013390. https:\/\/doi.org\/10.1007\/s00455-015-9687-1","journal-title":"Dysphagia"},{"key":"9076_CR37","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1007\/s40141-016-0134-5","volume":"4","author":"SA Watts","year":"2016","unstructured":"Watts SA, Tabor L, Plowman EK (2016) To Cough or Not to Cough? Examining the Potential Utility of Cough Testing in the Clinical Evaluation of Swallowing. Curr Phys Med Rehabil Rep 4:262\u2013276. https:\/\/doi.org\/10.1007\/s40141-016-0134-5","journal-title":"Curr Phys Med Rehabil Rep"},{"key":"9076_CR38","doi-asserted-by":"publisher","first-page":"41","DOI":"10.23736\/S1973-9087.19.05818-0","volume":"56","author":"JY Lim","year":"2020","unstructured":"Lim JY, Yoo YH, Park CH, Joa KL, Jung HY (2020) Use of the maximal phonation test for the screening of dysphagia in stroke patients: a preliminary study. Eur J Phys Rehabil Med 56:41\u201346. https:\/\/doi.org\/10.23736\/S1973-9087.19.05818-0","journal-title":"Eur J Phys Rehabil Med"},{"key":"9076_CR39","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1007\/s00455-021-10346-9","volume":"37","author":"L Mariani","year":"2022","unstructured":"Mariani L, Ruoppolo G, Cilfone A, Cocchi C, Preziosi Standoli J, Longo L, Ceccanti M, Greco A, Inghilleri M (2022) Progression of Oropharyngeal Dysphagia in Amyotrophic Lateral Sclerosis: A Retrospective Cohort Study. Dysphagia 37:868\u2013878. https:\/\/doi.org\/10.1007\/s00455-021-10346-9","journal-title":"Dysphagia"},{"key":"9076_CR40","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s00455-022-10486-6","volume":"38","author":"PP Zhang","year":"2023","unstructured":"Zhang PP, Yuan Y, Lu DZ, Li TT, Zhang H, Wang HY, Wang XW (2023) Diagnostic Accuracy of the Eating Assessment Tool-10 (EAT-10) in Screening Dysphagia: A Systematic Review and Meta-Analysis. Dysphagia 38:145\u2013158. https:\/\/doi.org\/10.1007\/s00455-022-10486-6","journal-title":"Dysphagia"}],"container-title":["Neurological Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-026-09076-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10072-026-09076-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-026-09076-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:05:46Z","timestamp":1780988746000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10072-026-09076-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":40,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["9076"],"URL":"https:\/\/doi.org\/10.1007\/s10072-026-09076-3","relation":{},"ISSN":["1590-1874","1590-3478"],"issn-type":[{"value":"1590-1874","type":"print"},{"value":"1590-3478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]},"assertion":[{"value":"28 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures contributing to this work involving human participants comply with the ethical standards of the Institutional Review Board and Institutional Guidelines on human experimentation and with the 2013 revision of the Helsinki Declaration of 1964.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval (in case humans were involved)"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors have no conflict of interest to report.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}],"article-number":"476"}}