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- Title
Gold-Standard? Analysis of the Videofluoroscopic and Fiberoptic Endoscopic Swallow Examinations.
- Authors
Rao, Noel; Brady, Susan L.; Chaudhuri, Gouri; Donzelli, Joseph J.; Wesling, Michele W.
- Abstract
Objective: The goal of this study was to determine sensitivity and specificity values for laryngeal penetration, tracheal aspiration, and pharyngeal residue for both the videofluoroscopic (VFSS) and fiberoptic endoscopic (FEES) swallowing examinations. Sensitivity and specificity values were calculated twice, first using the VFSS as the gold standard, then using the FEES as the gold standard. Percentage of agreement for laryngeal penetration, aspiration, pharyngeal residue, diet recommendations, and compensatory strategies were also calculated. Study Design: Prospective, consecutive design, set in a freestanding rehabilitation hospital. Participants: Eleven patients who underwent simultaneous VFSS and FEES. Interventions: Not applicable. Main Outcome Measures: Presence or absence of laryngeal penetration, tracheal aspiration, and/or pharyngeal residue. Results: When the VFSS was used as the gold standard, sensitivity of the FEES for laryngeal penetration was 0.87, aspiration 0.96, and pharyngeal residue 0.68. Specificity of the FEES for laryngeal penetration was 1.0, aspiration 1.0, and pharyngeal residue 0.98. When the FEES was used as the gold standard, sensitivity of the VFSS for laryngeal penetration was 1.0, aspiration 1.0, and pharyngeal residue 0.96. Specificity of the VFSS for laryngeal penetration was 0.58, aspiration 0.63, and pharyngeal residue 0.78. Agreement for the presence or absence of pharyngeal residue was 84.38%, laryngeal penetration 89.58%, and tracheal aspiration 96.69%. Diet recommendations were in agreement 100%, and compensatory swallowing strategies were in agreement 82%. Conclusions: The sensitivity values were higher when FEES was used as the gold standard, and the specificity values were higher when VFSS was used as the gold standard. The one exception is that the sensitivity values for aspiration, regardless of whether VFSS or FEES was used as the gold standard, were similar.
- Publication
Journal of Applied Research, 2003, Vol 3, Issue 1, p89
- ISSN
1537-064X
- Publication type
Academic Journal