Assessment of the role of the Edinburgh dysphagia score in referral triage in a national service evaluation of the urgent suspected upper gastrointestinal cancer pathway.

BACKGROUND: The British Society of Gastroenterology has recommended the Edinburgh Dysphagia Score (EDS) to risk-stratify dysphagia referrals during the endoscopy COVID recovery phase. AIMS: External validation of the diagnostic accuracy of EDS and exploration of potential changes to improve its diagnostic performance. METHODS: A prospective multicentre study of consecutive patients referred with dysphagia on an urgent suspected upper gastrointestinal (UGI) cancer pathway between May 2020 and February 2021. The sensitivity and negative predictive value (NPV) of EDS were calculated. Variables associated with UGI cancer were identified by forward stepwise logistic regression and a modified Cancer Dysphagia Score (CDS) developed. RESULTS: 1301 patients were included from 19 endoscopy providers; 43% male; median age 62 (IQR 51-73) years. 91 (7%) UGI cancers were diagnosed, including 80 oesophageal, 10 gastric and one duodenal cancer. An EDS ≥3.5 had a sensitivity of 96.7 (95% CI 90.7-99.3)% and an NPV of 99.3 (97.8-99.8)%. Age, male sex, progressive dysphagia and unintentional weight loss >3 kg were positively associated and acid reflux and localisation to the neck were negatively associated with UGI cancer. Dysphagia duration <6 months utilised in EDS was replaced with progressive dysphagia in CDS. CDS ≥5.5 had a sensitivity of 97.8 (92.3-99.7)% and NPV of 99.5 (98.1-99.9)%. Area under receiver operating curve was 0.83 for CDS, compared to 0.81 for EDS. CONCLUSIONS: In a national cohort, the EDS has high sensitivity and NPV as a triage tool for UGI cancer. The CDS offers even higher diagnostic accuracy. The EDS or CDS should be incorporated into the urgent suspected UGI cancer pathway.

Identification of sensory properties driving consumers' liking of commercially available kale and arugula.

BACKGROUND: Kale and arugula are leafy green vegetables whose sensory properties have not been extensively explored. The objective was to assess the sensory properties and consumer acceptability of commercially available kale and arugula while also discovering drivers of consumer liking and barriers to consumer acceptance. Descriptive analysis and consumer testing were completed. The trained panellists (n = 11) were trained for 15 h to evaluate 11 sensory properties relating to the aroma, taste and texture of the kale and arugula. The consumer testing (n = 108) evaluated the leafy greens for overall liking and their liking of taste, aroma, texture and appearance. RESULTS: Results were analyzed using ANOVA, Tukey's HSD and external preference mapping. Approximately half of the attributes for the kale samples were found to be significantly different. Similarly, significant differences in sensory properties were found in most of the arugula samples. Consumers liked the kale and arugula varieties that were sweet and nutty. Also, they preferred arugula that was described as spicy. CONCLUSION: The majority of consumers preferred sweet and nutty leafy greens. Organic growing methods did not affect consumer liking; however, organic labels do positively affect hedonic ratings of a consumer's overall liking of the product. This study also identified that 'Baby' leafy greens are well liked by consumers, and this area of produce should be expanded. © 2021 Society of Chemical Industry.