Sensitivity and specificity of clinical/bedside examination signs for detecting aspiration in adults subsequent to stroke.
While detecting the presence of aspiration is only one aspect of a noninstrumented examination of swallowing function, it is an important component due to its potential health status consequences. The purpose of this investigation was to investigate the sensitivity and specificity of clinical/bedside examination signs for predicting aspiration on videofluoroscopic examination of swallowing. Sixty consecutive, acute stroke patients were investigated with clinical/bedside and videofluoroscopic exams. Clinical signs consisted of history, oral motor/speech praxis, voice, and trial swallow ratings. Results confirm that more work needs to be done if data collected from noninstrumented examinations are to be strongly predictive of aspiration on VFSE. However, comparisons of the current results with previous investigations provides a promising framework for future research.


OBJECTIVE
(1) To understand the use of sensitivity and specificity in detecting disease; (2) To understand the current evidence regarding clinical signs of aspiration.
McCullough
G H
GH
University of Tennessee, Department of Audiology and Speech Pathology, Knoxville 37996, USA. gmccullo@utk.edu
Wertz
R T
RT
Rosenbek
J C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001072:Apraxias / Q000175:diagnosis / Q000209:etiology; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*; D014743:Videotape Recording; D014833:Voice Quality