Identification of Phenotypic Patterns of Dysphagia: A Proof of Concept Study

Am J Speech Lang Pathol. 2018 Aug 6;27(3):988-995. doi: 10.1044/2018_AJSLP-17-0173.

Abstract

Purpose: The purpose of the current project was to explore the feasibility for subtyping dysphagia traits or patterns of scores in a subset of data from the Modified Barium Swallow Impairment Profile global registry in patients referred to videofluoroscopic swallowing studies across 5 common medical categories: (a) cardiothoracic, (b) gastroenterology, (c) head and neck cancer, (d) neurology, and (e) pulmonary.

Method: Videofluoroscopic swallowing study imaging and Modified Barium Swallow Impairment Profile metrics were used to evaluate 235 patients with dysphagia grouped into 1 of the 5 categories. Two summative domain scores (oral total [OT] and pharyngeal total [PT]) and 17 component scores were tested for differences among the categories.

Results: When compared with the gastroenterology category, significantly higher OT/PT scores were observed in neurology and pulmonary categories (all p values < .05). Four oral and 6 pharyngeal domain components significantly differed across medical categories: tongue control during bolus hold (all p values < .04).

Conclusions: The results of this feasibility study demonstrate that summative scores of swallowing physiology alone are not sufficiently robust to distinguish subtypes of dysphagia in broad, heterogeneous medical categories. Using OT/PT as subtypes only separated gastroenterology from the other categories, suggesting overlap in OT/PT scores between the latter categories.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Barium Sulfate / administration & dosage*
  • Contrast Media / administration & dosage*
  • Deglutition Disorders / classification
  • Deglutition Disorders / diagnostic imaging*
  • Deglutition Disorders / physiopathology
  • Deglutition*
  • Esophagus / diagnostic imaging*
  • Esophagus / physiopathology
  • Feasibility Studies
  • Female
  • Fluoroscopy
  • Humans
  • Male
  • Middle Aged
  • Mouth / diagnostic imaging*
  • Mouth / physiopathology
  • Pharynx / diagnostic imaging*
  • Pharynx / physiopathology
  • Phenotype
  • Predictive Value of Tests
  • Proof of Concept Study
  • Registries
  • Reproducibility of Results
  • Video Recording
  • Viscosity
  • Young Adult

Substances

  • Contrast Media
  • Barium Sulfate