title: Validity of cervical auscultation in the screening for aspiration.
abstract: BACKGROUND
  Cervical auscultation could improve the performance of bedside swallowing test to predict aspiration, especially silent aspiration. The aim of this study is to compare the predictive values of bedside swallowing test performed with and without cervical auscultation by logopedist students who had intensive training on cervical auscultation.
  
  
  METHODS
  64 patients were included in the study. They all underwent swallowing test alone, combined swallowing test and cervical auscultation, and videofluoroscopic swallowing study as defined gold standard. Two logopedist students, at the end of their training, performed the auscultation and noted their results.
  
  
  RESULTS
  128 tests were performed, 96% of the tests were judged positive for aspiration. When comparing the results of the two different clinical tests, the detection of clinical signs is not improved by the addition of auscultation. Using a penetration aspiration scale threshold >5, the area under the curve measured for the swallowing test alone was significantly higher than that measured for the combined tests (p = 0.03) (0.66 for the swallowing test alone (95% CI between 0.49 and 0.83), and 0.50 for the combined tests (95% CI between 0.31 and 0.69).
  
  
  CONCLUSIONS
  This study showed no advantage in performing cervical auscultation with bedside swallowing test. Cervical auscultation seems to hamper the assessment, mainly the perception of wet voice and laryngeal motion. These results are compatible with literature but need further confirmation using studies performed with trained logopedists.
authors.forename: A
authors.initials: A
authors.lastname: Al Hawat
authors.forename: V
authors.initials: V
authors.lastname: Woisard
authors.forename: L
authors.initials: L
authors.lastname: Perez-Begout
authors.forename: E
authors.initials: E
authors.lastname: Sarrabère
authors.forename: S
authors.initials: S
authors.lastname: Grand
authors.forename: M
authors.initials: M
authors.lastname: Puech
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001314:Auscultation / Q000379:methods; D002648:Child; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D011237:Predictive Value of Tests; D011613:Psychotherapy / Q000193:education; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013334:Students