South of the UES: Improving the ability of speech-language pathologists to detect oesophageal abnormalities during videofluoroscopy swallowing studies.
IF 1.4 4区 医学Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Claire Stanley, Anthony Rotman, Dean McKenzie, Louise Malcolm, Paul Paddle
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引用次数: 0
Abstract
Purpose: With two-thirds of adults presenting for a videofluoroscopy swallow study (VFSS) with oesophageal abnormalities, it seems prudent to include visualisation of the oesophagus, in the context of the entire swallow process, to provide further information to the diagnostic team. This study aims to evaluate the ability of speech-language pathologists (SLPs) to interpret oesophageal sweep on VFSS and the relative improvement in that ability with additional training.
Method: One hundred SLPs attended training in oesophageal visualisation during VFSS, based on a previous study. Ten oesophageal sweep videos (five normal, five abnormal) with one 20 ml thin fluid barium bolus (19% w/v) were presented at baseline and following training. Raters were blinded to patient information other than age. Binary ratings were collected for oesophageal transit time (OTT), presence of stasis, redirection, and referral to other specialists.
Result: Inter-rater reliability as measured by Fleiss' kappa improved for all parameters, reaching statistical significance for OTT (pre-test kappa = 0.34, post-test kappa = 0.73; p < 0.01) and redirection (pre-test kappa = 0.38, post-test kappa = 0.49; p < 0.05). Overall agreement improved significantly (p < 0.001) for all parameters except stasis, where improvement was only slight. Interaction between pre-post and type of video (normal/abnormal) was statistically significant (p < 0.001) for redirection, with a large pre-post increase in positive accuracy compared with a slight pre-post decrease in negative accuracy.
Conclusion: Findings indicate that SLPs require training to accurately interpret an oesophageal sweep on VFSS. This supports the inclusion of education and training on both normal and abnormal oesophageal sweep patterns, and the use of standardised protocols for clinicians using oesophageal visualisation as part of the VFSS protocol.
期刊介绍:
International Journal of Speech-Language Pathology is an international journal which promotes discussion on a broad range of current clinical and theoretical issues. Submissions may include experimental, review and theoretical discussion papers, with studies from either quantitative and/or qualitative frameworks. Articles may relate to any area of child or adult communication or dysphagia, furthering knowledge on issues related to etiology, assessment, diagnosis, intervention, or theoretical frameworks. Articles can be accompanied by supplementary audio and video files that will be uploaded to the journal’s website. Special issues on contemporary topics are published at least once a year. A scientific forum is included in many issues, where a topic is debated by invited international experts.