title: Three tests for predicting aspiration without videofluorography.
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.
authors.affiliation: Department of Rehabilitation Medicine, Fujita Health University, Aichi, Japan. haruka-t@rd5.so-net.ne.jp
authors.forename: Haruka
authors.initials: H
authors.lastname: Tohara
authors.forename: Eiichi
authors.initials: E
authors.lastname: Saitoh
authors.forename: Keith A
authors.initials: KA
authors.lastname: Mays
authors.forename: Keith
authors.initials: K
authors.lastname: Kuhlemeier
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Palmer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014741:Video Recording