Clarifying Inaccurate Terminology: The Important Difference Between Dysphagia and Swallowing Dysfunction

Background: Dysphagia refers to the patient’s subjective experience. It is a symptom and should be differentiated from objective signs of swallowing impairment observed by healthcare providers. We hypothesized that there is rampant misuse of the term dysphagia in the medical literature. Objective: To evaluate the prevalence of the inaccurate use of the term dysphagia in the medical literature. Methods: A comprehensive database search was performed in PubMed, Ovid Embase, and the Cochrane Library to identify all 2019 English articles in the adult medicine literature containing the term dysphagia in the title, abstract and major topic in the medical subject heading. Risk factors for incorrect use of the term dysphagia were evaluated. Results: Our search yielded 2427 unique articles, 10% of which was randomly selected, accessed and included in the final analysis. The term dysphagia was misused in 39.1% (95/243) of these articles. The top specialties misusing the term were rehabilitation medicine, speech pathology and neurology. On univariate analysis, only the first author being a speech language pathologist was associated with significant odds of term misuse (OR = 12.2, 95% CI [1.2, 121.5]). Articles from Europe, the U.S.A and Korea had the highest incidence of misuse. Odds of incorrect use of dysphagia were significantly increased in cross-sectional studies (OR = 20.9, 95% CI [2.4-184.1]). Conclusion: The inaccurate use of the term dysphagia is widespread in the contemporary medical literature. This confusion undermines the patient’s experience, leads to misapplication of assessment tools, reduces data mining accuracy, and hinders innovation and patient care.