The American Broncho‐Esophagological Association Position Statement on Swallowing Fluoroscopy
Objectives To develop an expert consensus statement on the clinical use of swallowing fluoroscopy in adults that reduces practice variation and identifies opportunities for quality improvement in the care of patients suffering from swallowing impairment. Methodology A search strategist reviewed data...
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| Published in: | The Laryngoscope Vol. 133; no. 2; pp. 255 - 268 |
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| Main Authors: | , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Hoboken, USA
John Wiley & Sons, Inc
01.02.2023
Wiley Subscription Services, Inc |
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| ISSN: | 0023-852X, 1531-4995, 1531-4995 |
| Online Access: | Get full text |
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| Abstract | Objectives
To develop an expert consensus statement on the clinical use of swallowing fluoroscopy in adults that reduces practice variation and identifies opportunities for quality improvement in the care of patients suffering from swallowing impairment.
Methodology
A search strategist reviewed data sources (PubMed, Embase, Cochrane, Web of Science, Scopus) to use as evidence for an expert development group to compose statements focusing on areas of controversy regarding swallowing fluoroscopy. Candidate statements underwent two iterations of a modified Delphi protocol to reach consensus.
Results
A total of 2184 publications were identified for title and review with 211 publications meeting the criteria for full text review. Of these, 148 articles were included for review. An additional 116 publications were also included after reviewing the references of the full text publications from the initial search. These 264 references guided the authors to develop 41 candidate statements in various categories. Forty statements encompassing patient selection, fluoroscopic study choice, radiation safety, clinical team dynamics, training requirements, videofluoroscopic swallow study and esophagram techniques, and interpretation of swallowing fluoroscopy met criteria for consensus. One statement on esophagram technique reached near‐consensus.
Conclusions
These 40 statements pertaining to the comprehensive use of swallowing fluoroscopy in adults can guide the development of best practices, improve quality and safety of care, and influence policy in both the outpatient and inpatient settings. The lack of consensus on some aspects of esophagram technique likely reflects gaps in knowledge and clinical practice variation and should be a target for future research. Laryngoscope, 133:255–268, 2023 |
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| AbstractList | ObjectivesTo develop an expert consensus statement on the clinical use of swallowing fluoroscopy in adults that reduces practice variation and identifies opportunities for quality improvement in the care of patients suffering from swallowing impairment.MethodologyA search strategist reviewed data sources (PubMed, Embase, Cochrane, Web of Science, Scopus) to use as evidence for an expert development group to compose statements focusing on areas of controversy regarding swallowing fluoroscopy. Candidate statements underwent two iterations of a modified Delphi protocol to reach consensus.ResultsA total of 2184 publications were identified for title and abstract review with 211 publications meeting the criteria for full text review. Of these, 148 articles were included for review. An additional 116 publications were also included after reviewing the references of the full text publications from the initial search. These 264 references guided the authors to develop 41 candidate statements in various categories. Forty statements encompassing patient selection, fluoroscopic study choice, radiation safety, clinical team dynamics, training requirements, videofluoroscopic swallow study and esophagram techniques, and interpretation of swallowing fluoroscopy met criteria for consensus. One statement on esophagram technique reached near‐consensus.ConclusionsThese 40 statements pertaining to the comprehensive use of swallowing fluoroscopy in adults can guide the development of best practices, improve quality and safety of care, and influence policy in both the outpatient and inpatient settings. The lack of consensus on some aspects of esophagram technique likely reflects gaps in knowledge and clinical practice variation and should be a target for future research. Laryngoscope, 133:255–268, 2023 Objectives To develop an expert consensus statement on the clinical use of swallowing fluoroscopy in adults that reduces practice variation and identifies opportunities for quality improvement in the care of patients suffering from swallowing impairment. Methodology A search strategist reviewed data sources (PubMed, Embase, Cochrane, Web of Science, Scopus) to use as evidence for an expert development group to compose statements focusing on areas of controversy regarding swallowing fluoroscopy. Candidate statements underwent two iterations of a modified Delphi protocol to reach consensus. Results A total of 2184 publications were identified for title and review with 211 publications meeting the criteria for full text review. Of these, 148 articles were included for review. An additional 116 publications were also included after reviewing the references of the full text publications from the initial search. These 264 references guided the authors to develop 41 candidate statements in various categories. Forty statements encompassing patient selection, fluoroscopic study choice, radiation safety, clinical team dynamics, training requirements, videofluoroscopic swallow study and esophagram techniques, and interpretation of swallowing fluoroscopy met criteria for consensus. One statement on esophagram technique reached near‐consensus. Conclusions These 40 statements pertaining to the comprehensive use of swallowing fluoroscopy in adults can guide the development of best practices, improve quality and safety of care, and influence policy in both the outpatient and inpatient settings. The lack of consensus on some aspects of esophagram technique likely reflects gaps in knowledge and clinical practice variation and should be a target for future research. Laryngoscope, 133:255–268, 2023 To develop an expert consensus statement on the clinical use of swallowing fluoroscopy in adults that reduces practice variation and identifies opportunities for quality improvement in the care of patients suffering from swallowing impairment.OBJECTIVESTo develop an expert consensus statement on the clinical use of swallowing fluoroscopy in adults that reduces practice variation and identifies opportunities for quality improvement in the care of patients suffering from swallowing impairment.A search strategist reviewed data sources (PubMed, Embase, Cochrane, Web of Science, Scopus) to use as evidence for an expert development group to compose statements focusing on areas of controversy regarding swallowing fluoroscopy. Candidate statements underwent two iterations of a modified Delphi protocol to reach consensus.METHODOLOGYA search strategist reviewed data sources (PubMed, Embase, Cochrane, Web of Science, Scopus) to use as evidence for an expert development group to compose statements focusing on areas of controversy regarding swallowing fluoroscopy. Candidate statements underwent two iterations of a modified Delphi protocol to reach consensus.A total of 2184 publications were identified for title and abstract review with 211 publications meeting the criteria for full text review. Of these, 148 articles were included for review. An additional 116 publications were also included after reviewing the references of the full text publications from the initial search. These 264 references guided the authors to develop 41 candidate statements in various categories. Forty statements encompassing patient selection, fluoroscopic study choice, radiation safety, clinical team dynamics, training requirements, videofluoroscopic swallow study and esophagram techniques, and interpretation of swallowing fluoroscopy met criteria for consensus. One statement on esophagram technique reached near-consensus.RESULTSA total of 2184 publications were identified for title and abstract review with 211 publications meeting the criteria for full text review. Of these, 148 articles were included for review. An additional 116 publications were also included after reviewing the references of the full text publications from the initial search. These 264 references guided the authors to develop 41 candidate statements in various categories. Forty statements encompassing patient selection, fluoroscopic study choice, radiation safety, clinical team dynamics, training requirements, videofluoroscopic swallow study and esophagram techniques, and interpretation of swallowing fluoroscopy met criteria for consensus. One statement on esophagram technique reached near-consensus.These 40 statements pertaining to the comprehensive use of swallowing fluoroscopy in adults can guide the development of best practices, improve quality and safety of care, and influence policy in both the outpatient and inpatient settings. The lack of consensus on some aspects of esophagram technique likely reflects gaps in knowledge and clinical practice variation and should be a target for future research. Laryngoscope, 133:255-268, 2023.CONCLUSIONSThese 40 statements pertaining to the comprehensive use of swallowing fluoroscopy in adults can guide the development of best practices, improve quality and safety of care, and influence policy in both the outpatient and inpatient settings. The lack of consensus on some aspects of esophagram technique likely reflects gaps in knowledge and clinical practice variation and should be a target for future research. Laryngoscope, 133:255-268, 2023. To develop an expert consensus statement on the clinical use of swallowing fluoroscopy in adults that reduces practice variation and identifies opportunities for quality improvement in the care of patients suffering from swallowing impairment. A search strategist reviewed data sources (PubMed, Embase, Cochrane, Web of Science, Scopus) to use as evidence for an expert development group to compose statements focusing on areas of controversy regarding swallowing fluoroscopy. Candidate statements underwent two iterations of a modified Delphi protocol to reach consensus. A total of 2184 publications were identified for title and abstract review with 211 publications meeting the criteria for full text review. Of these, 148 articles were included for review. An additional 116 publications were also included after reviewing the references of the full text publications from the initial search. These 264 references guided the authors to develop 41 candidate statements in various categories. Forty statements encompassing patient selection, fluoroscopic study choice, radiation safety, clinical team dynamics, training requirements, videofluoroscopic swallow study and esophagram techniques, and interpretation of swallowing fluoroscopy met criteria for consensus. One statement on esophagram technique reached near-consensus. These 40 statements pertaining to the comprehensive use of swallowing fluoroscopy in adults can guide the development of best practices, improve quality and safety of care, and influence policy in both the outpatient and inpatient settings. The lack of consensus on some aspects of esophagram technique likely reflects gaps in knowledge and clinical practice variation and should be a target for future research. Laryngoscope, 133:255-268, 2023. |
| Author | Kuhn, Maggie Rameau, Anaïs Nativ‐Zeltzer, Nogah Fritz, Mark Allen, Jacqueline Morimoto, Linda Nayeli Starmer, Heather Dhar, Shumon Ian O'Rourke, Ashli Postma, Gregory Cates, Daniel Randall, Derrick R. Belafsky, Peter Evangelista, Lisa |
| Author_xml | – sequence: 1 givenname: Shumon Ian orcidid: 0000-0001-9873-8641 surname: Dhar fullname: Dhar, Shumon Ian email: shumon.dhar@utsouthwestern.edu organization: University of Texas Southwestern Medical Center – sequence: 2 givenname: Nogah orcidid: 0000-0003-1511-5321 surname: Nativ‐Zeltzer fullname: Nativ‐Zeltzer, Nogah organization: University of California, Davis Medical Center – sequence: 3 givenname: Heather orcidid: 0000-0002-1716-9852 surname: Starmer fullname: Starmer, Heather organization: Stanford University – sequence: 4 givenname: Linda Nayeli surname: Morimoto fullname: Morimoto, Linda Nayeli organization: Stanford University – sequence: 5 givenname: Lisa orcidid: 0000-0002-7825-1497 surname: Evangelista fullname: Evangelista, Lisa organization: University of California, Davis Medical Center – sequence: 6 givenname: Ashli surname: O'Rourke fullname: O'Rourke, Ashli organization: Medical University of South Carolina – sequence: 7 givenname: Mark surname: Fritz fullname: Fritz, Mark organization: University of Kentucky – sequence: 8 givenname: Anaïs orcidid: 0000-0003-1543-2634 surname: Rameau fullname: Rameau, Anaïs organization: Weill Cornell Medical College – sequence: 9 givenname: Derrick R. orcidid: 0000-0002-5542-1916 surname: Randall fullname: Randall, Derrick R. organization: University of Calgary – sequence: 10 givenname: Daniel orcidid: 0000-0001-8016-6091 surname: Cates fullname: Cates, Daniel organization: University of California, Davis Medical Center – sequence: 11 givenname: Jacqueline surname: Allen fullname: Allen, Jacqueline organization: University of Auckland – sequence: 12 givenname: Gregory surname: Postma fullname: Postma, Gregory organization: Medical College of Georgia at Augusta University – sequence: 13 givenname: Maggie surname: Kuhn fullname: Kuhn, Maggie organization: University of California, Davis Medical Center – sequence: 14 givenname: Peter surname: Belafsky fullname: Belafsky, Peter organization: University of California, Davis Medical Center |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35543231$$D View this record in MEDLINE/PubMed |
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| Copyright | 2022 The American Laryngological, Rhinological and Otological Society, Inc. 2023 The American Laryngological, Rhinological and Otological Society, Inc. |
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| Keywords | dysphagia esophagram modified barium swallow barium swallow |
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| Notes | Ashli O'Rourke is a consultant for GI‐Supply/Laborie Medical. Anaïs Rameau is a consultant for Perceptron Health, Inc. Gregory Postma is a consultant and speaker for Cook Medical LLC. Peter Belafsky is the co‐founder of Reflux Gourmet LLC. The authors have no other funding, financial relationships, or conflicts of interests to disclose. th Presented as a podium presentation at the American Broncho‐Esophagological Society Annual Meeting at COSM in Dallas, Texas on April 29 2022. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23 |
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To develop an expert consensus statement on the clinical use of swallowing fluoroscopy in adults that reduces practice variation and identifies... To develop an expert consensus statement on the clinical use of swallowing fluoroscopy in adults that reduces practice variation and identifies opportunities... ObjectivesTo develop an expert consensus statement on the clinical use of swallowing fluoroscopy in adults that reduces practice variation and identifies... |
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| SubjectTerms | Adult barium swallow Consensus Deglutition Deglutition Disorders - diagnostic imaging Deglutition Disorders - therapy dysphagia esophagram Fluoroscopy - methods Humans Laryngoscopy modified barium swallow Swallowing |
| Title | The American Broncho‐Esophagological Association Position Statement on Swallowing Fluoroscopy |
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