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 probability of each swallowing task ... Research Article
Newly Published
Research Article  |   June 15, 2017
Identification of Swallowing Tasks From a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment
 
Author Affiliations & Notes
  • R. Jordan Hazelwood
    Medical University of South Carolina, College of Health Professions, Department of Health Sciences and Research, Charleston
    Medical University of South Carolina, College of Medicine, Department of Otolaryngology–Head and Neck Surgery, Charleston
    Appalachian State University, Beaver College of Heath Sciences, Department of Communication Sciences and Disorders, Boone, NC
  • Kent E. Armeson
    Medical University of South Carolina, College of Medicine, Department of Public Health Sciences, Charleston
  • Elizabeth G. Hill
    Medical University of South Carolina, College of Medicine, Department of Public Health Sciences, Charleston
  • Heather Shaw Bonilha
    Medical University of South Carolina, College of Health Professions, Department of Health Sciences and Research, Charleston
    Medical University of South Carolina, College of Medicine, Department of Otolaryngology–Head and Neck Surgery, Charleston
  • Bonnie Martin-Harris
    Medical University of South Carolina, College of Health Professions, Department of Health Sciences and Research, Charleston
    Medical University of South Carolina, College of Medicine, Department of Otolaryngology–Head and Neck Surgery, Charleston
    Northwestern University, School of Communication, Department of Communication Sciences and Disorders, Evanston, IL
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to R. Jordan Hazelwood: hazelwoodrj@appstate.edu
  • Editor: Julie Liss
    Editor: Julie Liss×
  • Associate Editor: Catriona Steele
    Associate Editor: Catriona Steele×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Newly Published / Research Article
Research Article   |   June 15, 2017
Identification of Swallowing Tasks From a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment
Journal of Speech, Language, and Hearing Research, Newly Published. doi:10.1044/2017_JSLHR-S-16-0117
History: Received March 24, 2016 , Revised September 26, 2016 , Accepted December 29, 2016
 
Journal of Speech, Language, and Hearing Research, Newly Published. doi:10.1044/2017_JSLHR-S-16-0117
History: Received March 24, 2016; Revised September 26, 2016; Accepted December 29, 2016

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 (≤ .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.

Acknowledgments
Grants K23DC005764 (awarded to B. Martin-Harris), 1K24DC12801 (awarded to B. Martin-Harris), and T32DC0014435 (awarded to J. Dubno) from The National Institute on Deafness and Other Communication Disorders and the Global Investigator Initiated Research Grant from Bracco Diagnostics, Inc., (awarded to the MUSC Health Evelyn Trammell Institute for Voice and Swallowing) supported this work. We thank J. Blair and J. Wilmskötter for their assistance with manuscript review. Portions of this work were presented as a scientific paper at the 24th Annual Meeting of the Dysphagia Research Society in Chicago, Illinois (March 2015) and accepted as an oral presentation at the 51st Annual Perry V. Halushka Student Research Day at the Medical University of South Carolina in Charleston, South Carolina (November 2016).
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