DIGEST Grades Remain Stable With Inclusion of Moderately Thickened Liquids in the Videofluoroscopic Examination in Individuals With Amyotrophic Lateral Sclerosis.
Purpose: The Dynamic Imaging Grade of Swallowing Toxicity (Version 2; DIGEST) is a videofluoroscopy (VF) scale that measures pharyngeal swallowing severity based on functional measures of swallowing safety and efficiency. Original validation is based on a standard VF testing protocol including thin...
| Publicado en: | Journal of Speech, Language & Hearing Research Vol. 69; no. 6; pp. 2475 - 2481 |
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| Autores principales: | , , , , |
| Formato: | Artículo |
| Publicado: |
American Speech-Language-Hearing Association
Jun2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=194600806&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 194600806 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 10924388 1SM jtl: Journal of Speech, Language & Hearing Research issn: 10924388 maglogo: N pubinfo: dt: Jun2026 vid: 69 iid: 6 pid: 42 pub: American Speech-Language-Hearing Association artinfo: ui: 194600806 10.1044/2026_JSLHR-25-00478 ppf: 2475 ppct: 6 formats: fmt: @attributes: type: P size: 277KB tig: atl: DIGEST Grades Remain Stable With Inclusion of Moderately Thickened Liquids in the Videofluoroscopic Examination in Individuals With Amyotrophic Lateral Sclerosis. aug: au: Kallambettu, Veena Maureen, Folsom Chapin, Jennifer Hutcheson, Katherine Plowman, Emily affil: Aerodigestive Research Core Laboratory, The Ohio State University, Columbus Department of Otolaryngology--Head and Neck Surgery, The Ohio State University, Columbus Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston su: United States Patient safety Pharynx physiology Medical protocols Cancer treatment Academic medical centers Secondary analysis Research funding Barium sulfate Severity of illness index Descriptive statistics Amyotrophic lateral sclerosis Pharynx X-rays Viscosity Statistics Deglutition Data analysis software Deglutition disorders Fluoroscopy Specialty hospitals Disease complications sug: subj: Patient safety United States Specialty (except Psychiatric and Substance Abuse) Hospitals Pharynx physiology Medical protocols Cancer treatment Academic medical centers Secondary analysis Research funding Barium sulfate Severity of illness index Descriptive statistics Amyotrophic lateral sclerosis Pharynx X-rays Viscosity Statistics Deglutition Data analysis software Deglutition disorders Fluoroscopy Specialty hospitals Disease complications ab: Purpose: The Dynamic Imaging Grade of Swallowing Toxicity (Version 2; DIGEST) is a videofluoroscopy (VF) scale that measures pharyngeal swallowing severity based on functional measures of swallowing safety and efficiency. Original validation is based on a standard VF testing protocol including thin liquid, puree, and solid consistencies. Given that thickened liquid bolus trials are common in VF clinical testing protocols, we sought to determine the agreement in DIGEST grades with and without the inclusion of moderately thick liquid bolus trials on DIGEST outcomes in people with amyotrophic lateral sclerosis (pALS). Method: This study represents a secondary analysis of VF examinations from a prospective longitudinal study conducted in 109 pALS. VF evaluations contained 10 barium trials spanning three International Dysphagia Diet Standardisation Initiative (IDDSI) levels (0-7). Duplicate, independent, and blinded ratings were completed. DIGEST Efficiency and Safety grading was then completed under two conditions--with and without the inclusion of moderately thick liquid bolus trials into DIGEST grading--to produce two sets of DIGEST ratings for each VF study. Descriptives, percent agreement, and a weighted Cohen's kappa were performed on DIG EST grades. Results: A total of 373 VF examinations were included in this analysis. DIGEST grade percent agreement with and without IDDSI Level 3 was excellent for Safety (98.1%), Efficiency (93.8%), and Total (94.1%) grades. Kappa values for Safety, Efficiency, and Total grades were .96, .89, and .91, respectively, indicating excellent agreement across bolus trial inclusion methods. Conclusions: Standard inclusion of moderately thick liquid bolus trials did not significantly impact DIGEST grading in this data set. These results add to the preliminary but growing evidence suggesting stability of DIGEST grading with alternate bolus protocols in another patient population. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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