{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T08:55:33Z","timestamp":1791190533135,"version":"4.1.0"},"reference-count":29,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Folia Phoniatr Logop"],"abstract":"<jats:p>&lt;p&gt;Introduction: Flexible endoscopic evaluation of swallowing (FEES) is one of two diagnostic gold standards for pharyngeal dysphagia in patients with head and neck cancer (HNC). However, an evidence-based summary outcome measure was missing until recently. The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) for FEES was adapted from DIGEST&lt;sub&gt;V2&lt;\/sub&gt; for videofluoroscopy for this purpose and is a validated analysis method, grading the severity of pharyngeal dysphagia based on the swallowing parameters safety and efficiency. Main aim of this study was to translate and validate DIGEST-FEES into German (DIGEST-FEES-G). Methods: First, the transcultural translation included forward and backward translations, cognitive interviews, and consensus in an expert committee together with the original developers. Subsequently, the 100 endoscopic examination videos of the DIGEST-FEES original validation study were retrospectively analyzed with DIGEST-FEES-G. Results: After a training phase, inter-rater reliability was almost perfect for overall DIGEST-FEES-G grade (Kw = 0.89), DIGEST-FEES-G safety (Kw = 0.9), and DIGEST-FEES-G efficiency (Kw = 0.88). Intra-rater reliability for the DIGEST-FEES-G rating was almost perfect (rater 1: Kw = 0.81\u20130.88) and substantial to almost perfect (rater 2: Kw = 0.78\u20130.92). Overall DIGEST-FEES-G grade correlated with the German Murray Secretion Scale (r = 0.47; p &lt; 0.01), German Yale Vallecular Residue (r = 0.74; p &lt; 19 0.01), and German Yale Pyriform Sinus Residue (r = 0.66; p &lt; 0.01). Conclusion: The validation and reliability findings of the original study could be replicated for DIGEST-FEES-G which increases validity of the DIGEST-FEES scale. The translated version, DIGEST-FEES-G, provides a psychometrically sound analysis method for the severity grading of pharyngeal dysphagia in HNC for German-speaking practitioners.&lt;\/p&gt;<\/jats:p>","DOI":"10.1159\/fpl\/acvag009","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:20:49Z","timestamp":1787570449000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Transcultural Adaptation and Validation of the German DIGEST-FEES"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6693-8259","authenticated-orcid":false,"given":"Susanne","family":"Bauer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Rieser-Reetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg E.","family":"Bohlender","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather M.","family":"Starmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Hutcheson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meike","family":"Brockmann-Bauser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1891\/9780826137784.0025"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-06507-5"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.302"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000260"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1055\/a-0596-7780"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17010009"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12526"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s40136-023-00445-6"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1186\/s41687-020-00248-z"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30283"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34079"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1044\/2021_JSLHR-21-00014"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-023-10650-6"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.70008"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31814"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-025-10857-9"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-024-10759-2"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2010.01434.x"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1007\/BF00417897"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-013-2815-z"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1007\/BF00417898"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1385848"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-015-9631-4"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-018-9935-2"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1037\/h0026256"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-021-10293-5"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-023-07902-4"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-024-10733-y"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820933883"}],"container-title":["Folia Phoniatrica et Logopaedica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/fpl\/acvag009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T08:30:56Z","timestamp":1791189056000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/fpl\/acvag009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":29,"URL":"https:\/\/doi.org\/10.1159\/fpl\/acvag009","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.33320586","asserted-by":"subject"}]},"ISSN":["1021-7762","1421-9972"],"issn-type":[{"value":"1021-7762","type":"print"},{"value":"1421-9972","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]}}}