The semisolid bolus swallow test for clinical diagnosis of oropharyngeal dysphagia: a prospective randomised studyReport as inadecuate

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European Archives of Oto-Rhino-Laryngology

, Volume 268, Issue 12, pp 1837–1844

First Online: 24 May 2011Received: 28 January 2011Accepted: 02 May 2011


Contrary to clinical experience, clinical swallow tests are predominantly performed using water water swallow tests, WST. In this study, we examine whether swallow tests performed using a bolus of semisolid food bolus swallow test, BST offer benefits. In a prospective, randomised, blind study, the results of a standardised saliva swallow test SST, WST, BST, combinations of these tests and an endoscopic swallow test FEES in patients with oropharyngeal swallowing disorders of neurological NEU and non-neurological NNEU origin were compared. Sensitivity, specificity, test accuracy and inter-rater reliability were analysed. 62 patients mean age = 64.68; range = 22–84 were included in the study NEU = 40; NNEU = 22. A sensitivity of 70.7% NEU = 70.3%, NNEU = 71.4% and specificity of 82.5% NEU = 92.3%; NNEU = 100% were determined for the WST. The BST + SST was found to have a sensitivity of 89.6% NEU = 66.7%; NNEU = 90.9% and a specificity of 72.7% NEU = 87.5%; NNEU = 90.9%. Analysis of test accuracy showed a statistically significant correlation between FEES and BST + SST. Only BST + SST exhibited statistically significant inter-rater reliability. BST in combination with SST was the sensitive clinical instrument for detecting aspiration both over the patient population as a whole and over the two sub-populations. Inter-rater reliability was found to be statistically significant. The results presented here demonstrate the benefit of semisolid food in investigating clinical dysphagia.

KeywordsDysphagia Clinical screening Aspiration Water swallow test Bolus swallow test  Download fulltext PDF

Author: Corinna Schultheiss - Ricki Nusser-Müller-Busch - Rainer O. Seidl


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