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Munich Dysphagia Test - Parkinson's Disease (MDT-PD)
Please visit this website for more information about the instrument: Munich Dysphagia Test - Parkinson's Disease
Exploratory: Parkinson's Disease (PD)
Short Description of Instrument
The Munich Dysphagia Test - Parkinson's Disease (MDT-PD) is a 26-item patient-reported outcome questionnaire for early diagnosis of dysphagia in patients with Parkinson's disease. It includes subscales addressing four areas: Difficulty swallowing food and liquids (10 items), Difficulty swallowing independent from food intake (4 items), Further swallowing-specific and accompanying burden (9 items), and Swallowing-specific health questions (3 items).
Comments/Special Instructions
A cost-and license-free web application is available that provides a clinical interpretation of the MDT-PD sum score, allocated to the classifications "no dysphagia", "oropharyngeal dysphagia", and "dysphagia with risk of aspiration."  Both the MDT-PD questionnaire and the web application can be accessed at
Scoring and Psychometric Properties
Scoring:  For the first three subscales, answers are scored 0-3 (0= I disagree; 1= I somewhat disagree; 2= I mostly agree; 3= I strongly agree). For the final subscale, answers are score either 0 or 3 (0=No, I don't agree; 3=Yes, I agree).
Psychometric Properties: In the initial validation study, the MDT-PD demonstrated high internal consistency, with a Cronbach's alpha of 0.91. The test-retest reliability of the MDT-PD was not determined.  Additional statistical data can be found in the initial publication (Simons, et al., 2014) and at the MDT-PD website ( Weighting the MDT-PD sum score resulted in a higher predictive ability compared to the unweighted score.
Strengths: The MDT-PD is a relatively brief and straightforward scale that can be completed by the patient in <10 minutes. It is aimed at detecting early symptoms of dysphagia that might otherwise go unnoticed. In the initial validation study (Simons et al., 2014), it was noted to detect dysphagia with high sensitivity and specificity. The availability of the web application to obtain a clinical interpretation of the weighted MDT-PD score is also notable.
Weaknesses: A subsequent prospective study (Buhmann et al., 2019) reported a low sensitivity of the MDT-PD for detecting clinically-relevant aspiration in Parkinson's disease patients and suggested that a "readjustment of the MDT-PD is needed."
Key Reference:
Simons JA, Fietzek UM, Waldmann A, Warnecke T, Schuster T, Ceballos-Baumann AO. Development and validation of a new screening questionnaire for dysphagia in early stages of Parkinson's disease. Parkinsonism Relat Disord. 2014 Sep;20(9):992-8.
Additional Reference:
Buhmann C, Flugel T, Bihler M, Gerloff C, Niessen A, Hidding U, Nienstedt JC, Pflug C. Is the Munich Dysphagia Test - Parkinson's Disease (MDT-PD) a valid screening tool for patients at risk for aspiration? Parkinsonism Relat Disord. 2019 Apr;61:138-143.
Document last updated August 2022