title: Clinical experience using the Mann assessment of swallowing ability for identification of patients at risk for aspiration in a mixed-disease population.
abstract: OBJECTIVE
  To determine the clinical performance characteristics of the Mann Assessment of Swallowing Ability (MASA) for predicting aspiration (determined by videofluoroscopic swallowing study [VFSS]) in a mixed population.
  
  
  METHODS
  We selected 133 cases clinically evaluated using MASA and VFSS from January through June 2007. Ordinal risk rating (ORR) and total numeric score (TNS) were evaluated as predictors of aspiration on VFSS. To account for missing items, the maximum possible score was determined and a weighted percentage score calculated for each patient. We used receiver operating characteristic (ROC) analysis to compare the sensitivity and specificity of ORR and TNS for predicting aspiration.
  
  
  RESULTS
  VFSS identified 51 (38.4%) aspirators, while ORR identified 54 (40.6%) as probable or definite aspiration and TNS 19 (14.3%) as moderate to severe aspiration risk. ROC analysis demonstrated an area under the curve of 0.74, 95% CI [0.66, 0.82], for ORR and 0.51, 95% CI [0.41, 0.61], for TNS. These ROC scores suggest that the MASA ORR is better at predicting aspiration on VFSS than the numeric score.
  
  
  CONCLUSIONS
  In this sample, the subjective ORR had good predictive ability, while the percentage TNS failed to predict aspiration on VFSS. The MASA ORR assessment was a better predictor for a patient's aspiration risk in this population.
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA. mgonzal5@jhmi.edu
authors.forename: Marlís
authors.initials: M
authors.lastname: González-Fernández
authors.forename: Michael T
authors.initials: MT
authors.lastname: Sein
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Palmer
mesh_terms: D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013066:Speech-Language Pathology / Q000379:methods*