Content validation of a Danish version of "The McGill Ingestive Skills Assessment" for dysphagia management

This study addresses the first steps in the cross-cultural adaptation of a Danish version of the McGill Ingestive Skills Assessment (MISA), which quantifies eating and drinking abilities by scoring a meal observation. The original Canadian MISA was translated and adapted into Danish (MISA-DK). For content validation of the MISA-DK, a judgemental quantification process was applied using 13 experts. Thereafter, the MISA-DK was pilot tested by 16 occupational therapists. Finally, the MISA-DK was linked to the International Classification of Functioning, Disability and Health (ICF). Content validity of 43 items was found for 93% in terms of adequacy, 67% in terms of clarity of item description, 86% in terms of clarity of score descriptions, and 93% in terms of relevance. Thirteen of 14 sections of the instruction manual and score sheet were content valid. In light of these results, a revised MISA-DK was produced for the pilot test, which then found content validity for all sections and 98% of the items. The ICF linking resulted in 41 ICF-categories, which may reflect the complexity of eating and drinking as well as a multidimensional structure of the MISA-DK. In conclusion, the MISA-DK is prepared for psychometric testing using classical as well as modern test theory.