Hazelwood R Jordan, Armeson Kent E, Hill Elizabeth G, Bonilha Heather Shaw, Martin-Harris Bonnie
Medical University of South Carolina, College of Health Professions, Department of Health Sciences and Research, CharlestonMedical University of South Carolina, College of Medicine, Department of Otolaryngology-Head and Neck Surgery, CharlestonAppalachian State University, Beaver College of Heath Sciences, Department of Communication Sciences and Disorders, Boone, NC.
Medical University of South Carolina, College of Medicine, Department of Public Health Sciences, Charleston.
J Speech Lang Hear Res. 2017 Jul 12;60(7):1855-1863. doi: 10.1044/2017_JSLHR-S-16-0117.
The purpose of this study was to identify which swallowing task(s) yielded the worst performance during a standardized modified barium swallow study (MBSS) in order to optimize the detection of swallowing impairment.
This secondary data analysis of adult MBSSs estimated the probability of each swallowing task yielding the derived Modified Barium Swallow Impairment Profile (MBSImP™©; Martin-Harris et al., 2008) Overall Impression (OI; worst) scores using generalized estimating equations. The range of probabilities across swallowing tasks was calculated to discern which swallowing task(s) yielded the worst performance.
Large-volume, thin-liquid swallowing tasks had the highest probabilities of yielding the OI scores for oral containment and airway protection. The cookie swallowing task was most likely to yield OI scores for oral clearance. Several swallowing tasks had nearly equal probabilities (≤ .20) of yielding the OI score.
The MBSS must represent impairment while requiring boluses that challenge the swallowing system. No single swallowing task had a sufficiently high probability to yield the identification of the worst score for each physiological component. Omission of swallowing tasks will likely fail to capture the most severe impairment for physiological components critical for safe and efficient swallowing. Results provide further support for standardized, well-tested protocols during MBSS.
本研究的目的是确定在标准化改良钡餐吞咽造影检查（MBSS）期间，哪些吞咽任务的表现最差，以便优化吞咽障碍的检测。
这项对成人MBSS的二次数据分析，使用广义估计方程估计了每项吞咽任务得出改良钡餐吞咽障碍概况（MBSImP™©；Martin-Harris等人，2008年）总体印象（OI；最差）评分的概率。计算了吞咽任务的概率范围，以辨别哪些吞咽任务的表现最差。
大量稀薄液体吞咽任务得出口腔容纳和气道保护OI评分的概率最高。吞饼干任务最有可能得出口腔清除OI评分。几项吞咽任务得出OI评分的概率几乎相等（≤0.20）。
MBSS必须在要求对吞咽系统构成挑战的食团的同时体现出障碍。没有单一的吞咽任务有足够高的概率得出每个生理成分的最差评分。遗漏吞咽任务可能无法捕捉到对安全有效吞咽至关重要的生理成分的最严重障碍。结果为MBSS期间的标准化、经过充分测试的方案提供了进一步支持。
