Three tests for predicting aspiration without videofluorography

Haruka Tohara, Eiichi Saitoh, Keith A. Mays, Keith Kuhlemeier, Jeffrey B. Palmer

Research output: Contribution to journalArticle

Abstract

The videofluorographic swallowing study (VFSS) is the definitive test to identify aspiration and other abnormalities of swallowing. When a VFSS is not feasible, nonvideofluorographic (non-VFG) clinical assessment of swallowing is essential. We studied the accuracy of three non-VFG tests for assessing risk of aspiration: (1) the water swallowing test (3 ml of water are placed under the tongue and the patient is asked to swallow); (2) the food test (4 g of pudding are placed on the dorsum of the tongue and the patient asked to swallow); and (3) the X-ray test (static radiographs of the pharynx are taken before and after swallowing liquid barium). Sixty-three individuals with dysphagia were each evaluated with the three non-VFG tests and a VFSS; 29 patients aspirated on the VFSS. The summed scores of all three non-VFG tests had a sensitivity of 90% for predicting aspiration and specificity of 71% for predicting its absence. The summed scores of the water and food tests (without X-ray) had a sensitivity of 90% and specificity of 56%. These non-VFG tests have limitations but may be useful for assessing patients when VFSS is not feasible. They may also be useful as screening procedures to determine which dysphagia patients need a VFSS.

Original languageEnglish (US)
Pages (from-to)126-134
Number of pages9
JournalDysphagia
Volume18
Issue number2
DOIs
StatePublished - Mar 1 2003

Keywords

  • Aspiration
  • Deglutition
  • Deglutition disorders
  • Diagnostic techniques and procedures
  • ROC curve
  • Sensitivity and specificity

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Gastroenterology
  • Speech and Hearing

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  • Cite this

    Tohara, H., Saitoh, E., Mays, K. A., Kuhlemeier, K., & Palmer, J. B. (2003). Three tests for predicting aspiration without videofluorography. Dysphagia, 18(2), 126-134. https://doi.org/10.1007/s00455-002-0095-y