The Modified Barium Swallow Impairment Profile (MBSImP™©) – Innovation, Dissemination and Implementation

Abstract

The Modified Barium Swallow Impairment Profile (MBSImP™©) is a standardized method for the assessment of swallowing physiology from videofluoroscopic imaging used by teams of speech-language pathologists (SLPs) and radiologists during modified barium swallowing studies (MBSS). The approach is grounded in research and motivated by patient need toward minimizing wide variation in clinical practice and equivocal swallowing assessment findings when attempting to compare assessment results across the continuum of care and between clinical settings. Various methods of scoring are used, which are dependent upon the nature and purpose of the clinical or research question. The MBSImP™© initiated with an National Institute of Health [NIH] supported study has been field tested for 13 years. The standardized method aims to enhance the validity and reliability of swallowing metrics, improve transparency and reproducibility of clinical and research MBSS practices, as well as to optimize patient safety, comfort, expectations, and outcomes. The physiologic study of swallowing impairment using the MBSImP™© has become a program of research that strategically includes a data science initiative using a global registry of quality, safety and outcome metrics.

Aging Effects on Esophageal Transit Time in the Upright Position During Videofluoroscopy

“…Participants were administered 10 barium swallowing trials (Varibar®, Bracco Diagnostics, Inc.) of increasing volume and viscosity following the previously published MBSImP standardized procedure. [9][10] Participants were then repositioned into the anteroposterior viewing plane and subsequently presented with a 5 ml nectar-thickened (300 centipoize (cps), 40% weight/volume (w/v)) liquid trial via spoon and a 5 ml pudding (5750 cps, 40% w/v) trial via spoon per MBSImP protocol. [9][10] Continuous fluoroscopy was used and recordings were made with a resolution of 30 digital frames per second.…”

“…9-10 Component 17 is derived from two trials administered in the anteroposterior viewing plane – 5 ml nectar-thickened liquid and 5 ml pudding. 9-10…”

“…Further investigation of ETT in larger cohorts of healthy adults will continue to improve accuracy of normative ranges, particularly across standardized videofluoroscopic protocols routinely used in clinical settings such as the Modified Barium Swallow Impairment Profile (MBSImP). [9][10] The MBSImP assesses 17 physiologic components of swallowing, including one component related to esophageal clearance (Component 17) assessed in the anteroposterior viewing plane. [9][10] Component 17 is derived from two trials administered in the anteroposterior viewing plane -5 ml nectar-thickened liquid and 5 ml pudding.…”

“…[9][10] The MBSImP assesses 17 physiologic components of swallowing, including one component related to esophageal clearance (Component 17) assessed in the anteroposterior viewing plane. [9][10] Component 17 is derived from two trials administered in the anteroposterior viewing plane -5 ml nectar-thickened liquid and 5 ml pudding. [9][10] The purpose of this study was to examine aging effects on ETT observed during videofluoroscopy in the upright position and anteroposterior viewing plane during standardized administration of two swallowing trials in healthy, non-dysphagic adults.…”

“…[9][10] Component 17 is derived from two trials administered in the anteroposterior viewing plane -5 ml nectar-thickened liquid and 5 ml pudding. [9][10] The purpose of this study was to examine aging effects on ETT observed during videofluoroscopy in the upright position and anteroposterior viewing plane during standardized administration of two swallowing trials in healthy, non-dysphagic adults. Furthermore, we investigated sex differences on ETT, and the relationship between ETT and Esophageal Clearance score (MBSImP Component 17).…”