The American <scp>Broncho‐Esophagological</scp> Association Position Statement on Swallowing Fluoroscopy

Dhar, Shumon I.; Nativ‐Zeltzer, Nogah; Starmer, Heather M.; Morimoto, Linda Nayeli; Evangelista, Lisa; O’Rourke, Ashli; Fritz, Mark; Rameau, Anaïs; Randall, Derrick R.; Cates, Daniel J.; Allen, Jacqueline; Postma, Gregory; Kuhn, Maggie A.; Belafsky, Peter C.

doi:10.1002/lary.30177

Cited by 7 publications

(25 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…VFSS was conducted and reviewed by a trained multidisciplinary team including a speech‐language pathologist, radiology technician, and physician supervisor. Standardized lateral and anterior–posterior views were utilized, in addition to an esophageal screen for distal abnormalities 8 . Those who evaluated the swallow studies and logged their results did not receive EAT‐10 scores prior to assessment.…”

Section: Methodsmentioning

confidence: 99%

“…Standardized lateral and anterior-posterior views were utilized, in addition to an esophageal screen for distal abnormalities. 8 Those who evaluated the swallow studies and logged their results did not receive EAT-10 scores prior to assessment. A pre-established centralized data repository was utilized to track patients who presented to visits where a treating clinician selected dysphagia as their primary diagnosis.…”

Section: Dysphagia Diagnosesmentioning

confidence: 99%

“…Item response frequencies, item-total correlations, and chi-squared analyses assessing residual correlations between items suggested potential redundancy within the item pairs of [8,9] (χ 2 10.4), [3,5] (χ 2 8.3), [6,7] (χ 2 7.6), and [4,5] (χ 2 7.4), such that just one item within each of these pairs could be deemed sufficient from the statistical standpoint.…”

Section: Item Response Theory Analysismentioning

confidence: 99%

“…Finally, the third proposed subset included items designed to preserve the spectrum of difficulty offered by the original scale (EAT-5-Range, items 3,6,7,8,9). The item function curve demonstrated a lower peak than other subsets (Figure 1).…”

Section: Three Proposed 5-item Sets: Comparison To Eat-10mentioning

confidence: 99%

See 3 more Smart Citations

Can EAT‐10 Become EAT‐5? Improving Measurement Efficiency of Dysphagia with Item Response Theory

Ahanotu,

DeVore,

Carroll

et al. 2023

The Laryngoscope

Self Cite

View full text Add to dashboard Cite

ObjectivesTo assess: (1) the Eating Assessment Tool (EAT‐10) with item response theory (IRT) to determine which individual items provide the most information, (2) the extent to which dysphagia is measured with subsets of items while maintaining precise score estimates, and (3) if 5‐item scales have the differing discriminatory ability, as compared to the parent 10‐item instrument.MethodsProspectively collected data from 2,339 patients who completed the EAT‐10 questionnaire during evaluation at a tertiary care otolaryngology clinic were utilized. IRT analyses provided discrimination and location parameters associated with individual questions. Residual item correlations were also assessed for redundant information. Based on these results, three 5‐item subsets were further evaluated using item information function curves. Areas under receiver‐operator characteristic curves (ROC‐AUC) were also calculated to evaluate the discriminatory ability for dysphagia‐related clinical diagnoses.ResultsItem discrimination parameter estimates ranged from 1.71 to 5.46, with higher values indicating more information. Residual item correlations were determined within item pairs, and location parameters were calculated. Based on these data, in combination with clinical utility, three 5‐item subsets were proposed and assessed. ROC‐AUC analyses demonstrated no significant difference between the EAT‐5‐Alpha subset and the original 10‐item instrument for discriminating dysphagia as a primary diagnosis (0.88, 0.88). The EAT‐5‐Clinical subset outperformed the original 10 instruments in ROC‐AUC for aspiration. The EAT‐5‐Range subset was significantly associated with problems with thin liquids.ConclusionsIRT analyses distinguished three proposed 5‐item subsets of the EAT‐10 instrument, supporting shorter survey options, while still reflecting the impact of dysphagia without significant loss of discrimination.Level of Evidence3 (Diagnostic testing with consistently applied reference standards, partial blinding). Laryngoscope, 2023

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Dysphagia Diagnosesmentioning

confidence: 99%

Section: Item Response Theory Analysismentioning

confidence: 99%

Section: Three Proposed 5-item Sets: Comparison To Eat-10mentioning

confidence: 99%

See 2 more Smart Citations

Can EAT‐10 Become EAT‐5? Improving Measurement Efficiency of Dysphagia with Item Response Theory

Ahanotu,

DeVore,

Carroll

et al. 2023

The Laryngoscope

Self Cite

View full text Add to dashboard Cite

show abstract

“…We included 6 evidence-based guidelines with recommendations that were developed from systematic searches for relevant evidence. These guidelines were developed by groups in Korea, 11 the US, 12 Japan, 4 and Portugal. 13 Additionally, 2 guidelines were developed by multinational groups.…”

Section: Included Studies For Question 3: Evidence-based Guidelinesmentioning

confidence: 99%

Clinical and Instrumental Swallowing Assessments for Dysphagia

Haas,

Bailey

2024

cjht

View full text Add to dashboard Cite

What Is the Issue? Dysphagia, or swallowing impairment, is a common complication of many health conditions. To assess patients for dysphagia, speech-language pathologists may use instrumental swallowing assessments or clinical assessments. Instrumental swallowing assessments are more accurate and comprehensive, but they also require more time and resources. To help inform decisions about whether it is appropriate to increase use of clinical assessments and limit the use of instrumental swallowing assessments, it is important to understand current best practices as well as the comparative clinical utility and diagnostic accuracy. What Did We Do? We searched for literature evaluating the clinical utility and diagnostic accuracy of instrumental swallowing assessments versus clinical assessments for patients with suspected dysphagia. We also searched for evidence-based guidelines that provide recommendations about the use of instrumental and clinical assessments for suspected dysphagia. An information specialist searched for peer-reviewed and grey literature sources published between January 1, 2019, and November 30, 2023. What Did We Find? Four diagnostic test accuracy studies compared various clinical evaluations to instrumental swallowing exams. The tests ranged in their sensitivity, specificity, positive predictive values, and negative predictive values. Three of the 4 studies concluded that the clinical assessments they examined could be used to identify dysphagia. One of these 3 studies examined multiple clinical evaluations and noted the varying degrees of accuracy among the tests and indicated which of these is most accurate. The fourth study found that further evidence is needed to determine if a clinical feeding evaluation can predict aspiration. We did not find any studies directly evaluating the clinical utility of instrumental swallowing assessments versus clinical evaluation for patients with suspected dysphagia that met the inclusion criteria for this review. Six evidence-based guidelines made recommendations related to instrumental and clinical swallowing assessments for dysphagia. These recommendations generally indicated that instrumental assessments should be used when resources allow, or that they should take place in addition to clinical swallowing assessments. What Does This Mean? Health care practitioners may wish to conduct an instrumental swallowing assessment, such as a fibreoptic endoscopic evaluation of swallowing or a videofluoroscopic swallowing study for patients for whom there are sufficient resources to do so. Clinical assessments for dysphagia have the potential to help clinicians diagnose patients with dysphagia without the use of instrumental swallowing assessments, particularly in settings with limited resources. However, this is not the case for all clinical assessments and needs to be determined on a case-by-case basis.

show abstract

Correlations Between Anxiety and/or Depression Diagnoses and Dysphagia Severity

Doruk,

Mocchetti,

Rives

et al. 2023

The Laryngoscope

Self Cite

View full text Add to dashboard Cite

ObjectiveAn increased prevalence of mood and anxiety disorders in patients with dysphagia has been noted previously, but whether dysphagia severity may be exacerbated by anxiety and depression has never been studied before. The purpose of this study is to identify the effect of pre‐existing diagnosis of anxiety and/or depression (anxiety/depression) on the Eating Assessment Tool (EAT‐10), a validated patient‐reported outcome measure for dysphagia. We hypothesized that patients with dysphagia and normal instrumental evaluation have higher EAT‐10 score in the presence of pre‐existing anxiety and depression.MethodsA retrospective chart review was conducted of patients seen at the multi‐disciplinary dysphagia clinic of an urban academic institution. EAT‐10 scores and pre‐existing diagnoses of anxiety/depression were collected at the first visit with laryngologists. The two‐sample t‐test was used to compare mean EAT‐10 scores between the anxiety/depression and no anxiety/depression groups, stratified by swallowing dysfunction etiology.ResultsThe study included 290 consecutive patients seen starting in January 2018. In this cohort, 60 (21%) had pre‐existing anxiety, 49 (17%) depression, and 36 (12%) both. Overall, 59 patients had normal swallowing based on instrumental swallowing testing (flexible endoscopic evaluation of swallowing, videofluoroscopic swallow study, esophagram, or esophagoscopy). Among those, mean EAT‐10 score was significantly higher in patients with anxiety and/or depression (n = 30) (14.63, SD = 11.42) compared to those with no anxiety and/or depression (n = 29) (8.93, SD = 6.59) (p = 0.023).ConclusionWhile anxiety/depression may aggravate dysphagia in patients with normal swallowing function, this correlation may not hold in those with objective swallowing dysfunction.Level of Evidence4 Laryngoscope, 2023

show abstract

The American Broncho‐Esophagological Association Position Statement on Swallowing Fluoroscopy

Cited by 7 publications

References 87 publications

Can EAT‐10 Become EAT‐5? Improving Measurement Efficiency of Dysphagia with Item Response Theory

Can EAT‐10 Become EAT‐5? Improving Measurement Efficiency of Dysphagia with Item Response Theory

Clinical and Instrumental Swallowing Assessments for Dysphagia

Correlations Between Anxiety and/or Depression Diagnoses and Dysphagia Severity

Contact Info

Product

Resources

About