Construction of the index system for screening and assessment of dysphagia in Chinese elderly people based on Delphi method: An observational study

This study aimed to preliminarily construct a screening and evaluation index system for dysphagia in the elderly based on expert consensus, so as to provide a preliminary theoretical reference for subsequent clinical verification and optimized screening and assessment of elderly dysphagia patients. A systematic literature review was conducted to extract core items, and the preliminary framework was developed via team and expert discussion. A standardized dispute resolution mechanism was adopted during expert correspondence consultation. Reasons for retention, revision, or elimination of indicators were determined based on screening criteria and expert suggestions. The analytic hierarchy process (AHP) was used to verify the index weight system, and a consistency test (i.e., the consistency ratio [CR] value is <0.1) was applied to guarantee rationality. This study established a preliminary, expert consensus-based theoretical framework for elderly dysphagia screening and assessment. The expert panel demonstrated high enthusiasm and authority. However, the present framework has inherent limitations, including single-region expert sampling, moderate expert consensus consistency, and lack of prospective clinical validation. Three rounds of expert consultations were conducted among 19 specialists recruited from tertiary hospitals in a single regional area. The questionnaire response rates were 94.7%, 100%, and 100%, respectively. 17 (89.5%), 14 (73.7%), and 5 (26.3%) experts put forward revision suggestions in each round. The expert authority coefficient was 0.920, and Kendall coordination coefficients were 0.219, 0.261 and 0.306 (all P<.001), indicating statistically significant but only moderate expert agreement. The final index system consisted of 3 primary indicators, 10 secondary indicators, and 26 tertiary indicators.