Identification of Swallowing Tasks From a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment

Purpose: The purpose of this study was to identify which swallowing task(s) yielded the worst performance during a standardized modified barium swallow study (MBSS) in order to optimize the detection of swallowing impairment. Method: This secondary data analysis of adult MBSSs estimated the probabil...

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Bibliographic Details
Published in:Journal of speech, language, and hearing research Vol. 60; no. 7; pp. 1855 - 1863
Main Authors: Jordan Hazelwood, R., Armeson, Kent E., Hill, Elizabeth G., Bonilha, Heather Shaw, Martin-Harris, Bonnie
Format: Journal Article
Language:English
Published: United States American Speech-Language-Hearing Association 01.07.2017
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Barium
Contrast Media
Deglutition
Deglutition - physiology
Deglutition disorders
Deglutition Disorders - diagnosis
Deglutition Disorders - physiopathology
Diagnosis
Diagnostic Tests
Disability Identification
Female
Food
Humans
Male
Methods
Middle Aged
Physical Disabilities
Physical Stimulation
Physiological aspects
Probability
Prospective Studies
Severity (of Disability)
Speech
Upper GI series
Young Adult
ISSN:1092-4388, 1558-9102, 1558-9102
Online Access:Get full text
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Summary:Purpose: The purpose of this study was to identify which swallowing task(s) yielded the worst performance during a standardized modified barium swallow study (MBSS) in order to optimize the detection of swallowing impairment. Method: This secondary data analysis of adult MBSSs estimated the probability of each swallowing task yielding the derived Modified Barium Swallow Impairment Profile (MBSImP™©; Martin-Harris et al., 2008) Overall Impression (OI; worst) scores using generalized estimating equations. The range of probabilities across swallowing tasks was calculated to discern which swallowing task(s) yielded the worst performance. Results: Large-volume, thin-liquid swallowing tasks had the highest probabilities of yielding the OI scores for oral containment and airway protection. The cookie swallowing task was most likely to yield OI scores for oral clearance. Several swallowing tasks had nearly equal probabilities (= 0.20) of yielding the OI score. Conclusions: The MBSS must represent impairment while requiring boluses that challenge the swallowing system. No single swallowing task had a sufficiently high probability to yield the identification of the worst score for each physiological component. Omission of swallowing tasks will likely fail to capture the most severe impairment for physiological components critical for safe and efficient swallowing. Results provide further support for standardized, well-tested protocols during MBSS.
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Disclosure: The authors have declared that no competing interests existed at the time of publication.
Editor: Julie Liss
Associate Editor: Catriona Steele
ISSN:1092-4388
1558-9102
1558-9102
DOI:10.1044/2017_JSLHR-S-16-0117