Translation and Validation of the MD Anderson Dysphagia Inventory (MDADI) for Hebrew-Speaking Patients

Dysphagia is a common and disabling consequence of head and neck cancer treatment. Patient-reported outcome measures provide critical insight into swallowing-related quality of life. The M. D. Anderson Dysphagia Inventory is the most widely used disease-specific questionnaire for this purpose. This study aimed to translate, culturally adapt, and validate a Hebrew version of the M. D. Anderson Dysphagia Inventory for use among individuals with head and neck conditions.

This single-center psychometric validation study was conducted in the Department of Otolaryngology-Head and Neck Surgery at Sheba Medical Center. The translation followed the Principles of Good Practice of the International Society for Pharmacoeconomics and Outcomes Research. Adult Hebrew-speaking participants completed the translated inventory. Internal consistency, test-retest reliability, and construct validity were evaluated using Cronbach's alpha, intraclass correlation coefficients, correlation analyses, and known-groups comparisons against established quality-of-life instruments. Statistical analyses were performed in R using standardized psychometric methods.

Four hundred participants completed 416 questionnaires. Internal consistency was excellent across domains (Cronbach's alpha 0.87-0.95), and test-retest reliability showed strong temporal stability (intraclass correlation 0.82-0.90). Correlations among domains supported the original three-factor structure. Scores demonstrated expected clinical gradients across surgical exposure groups. Convergent validity was confirmed through strong correlations with established voice and quality-of-life measures.

The Hebrew version of the M. D. Anderson Dysphagia Inventory demonstrates excellent reliability and validity consistent with international adaptations. It enables standardized, patient-centered assessment of swallowing-related quality of life in Hebrew-speaking populations and facilitates cross-cultural research in head and neck oncology.