Reference Values for Videofluoroscopic Measures of Swallowing: An Update.

Purpose: It is essential that clinicians have evidence-based benchmarks to support accurate diagnosis and clinical decision making. Recent studies report poor reliability for diagnostic judgments and identifying mechanisms of impairment from videofluoroscopy (VFSS). Establishing VFSS reference value...

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Publicado en:Journal of Speech, Language & Hearing Research Vol. 66; no. 10; pp. 3804 - 3825
Autores principales: Steele, Catriona M., Bayley, Mark T., Bohn, Mary Kathryn, Higgins, Victoria, Kulasingam, Melanie, Vathany, Peladeau-Pigeon
Formato: Artículo
Publicado: American Speech-Language-Hearing Association Oct2023
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2023
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      pub: American Speech-Language-Hearing Association
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        10.1044/2023_jslhr-23-00246
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        atl: Reference Values for Videofluoroscopic Measures of Swallowing: An Update.
      aug:
        au:
          Steele, Catriona M.
          Bayley, Mark T.
          Bohn, Mary Kathryn
          Higgins, Victoria
          Kulasingam, Melanie
          Vathany, Peladeau-Pigeon
        affil:
          KITE Research Institute, University Health Network, Toronto, Ontario, Canada
          Canada Research Chair in Swallowing and Food Oral Processing, Canada Research Chairs Secretariat, Ottawa, Ontario
      su:
        Therapeutics
        Age distribution
        Task performance
        Quantitative research
        Reference values
        Deglutition
        Research evaluation
        Sample size (Statistics)
        Deglutition disorders
        Contrast media
        Fluoroscopy
        Benchmarking (Management)
        Inter-observer reliability
        Descriptive statistics
        Research funding
        Data analysis software
        Decision making in clinical medicine
        Reaction time
        Video recording
      sug:
        subj:
          Therapeutics
          Age distribution
          Task performance
          Quantitative research
          Reference values
          Deglutition
          Research evaluation
          Sample size (Statistics)
          Deglutition disorders
          Contrast media
          Fluoroscopy
          Benchmarking (Management)
          Inter-observer reliability
          Descriptive statistics
          Research funding
          Data analysis software
          Decision making in clinical medicine
          Reaction time
          Video recording
      ab: Purpose: It is essential that clinicians have evidence-based benchmarks to support accurate diagnosis and clinical decision making. Recent studies report poor reliability for diagnostic judgments and identifying mechanisms of impairment from videofluoroscopy (VFSS). Establishing VFSS reference values for healthy swallowing would help resolve such discrepancies. Steele et al. (2019) released preliminary reference data for quantitative VFSS measures in healthy adults aged < 60 years. Here, we extend that work to provide reference percentiles for VFSS measures across a larger age span. Method: Data for 16 VFSS parameters were collected from 78 healthy adults aged 21--82 years (39 male). Participants swallowed three comfortable sips each of thin, slightly, mildly, moderately, and extremely thick barium (20% w/v). VFSS recordings were analyzed in duplicate by trained raters, blind to participant and task, using the Analysis of Swallowing Physiology: Events, Kinematics and Timing (ASPEKT) Method. Reference percentiles (p2.5, 5, 25, 50, 75, 95, and 97.5) were determined as per Clinical and Laboratory Standards Institute EP28-A3c guidelines. Results: We present VFSS reference percentile tables, by consistency, for (a) timing parameters (swallow reaction time; the hyoid burst--to--upper esophageal sphincter (UES)-opening interval; UES opening duration; time--to--laryngeal vestibule closure (LVC); and LVC duration) and (b) anatomically scaled pixel-based measures of maximum UES diameter, pharyngeal area at maximum pharyngeal constriction and rest, residue (vallecular, pyriform, other pharyngeal locations, total), and hyoid kinematics (X, Y, XY coordinates of peak position; speed). Clinical decision limits are proposed to demarcate atypical values of potential clinical concern. Conclusion: These updated reference percentiles and proposed clinical decision limits are intended to support interpretation and reliability for VFSS assessment data.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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