Impact of Reducing Fluoroscopy Pulse Rate on Adult Modified Barium Swallow Studies.
Heather Shaw Bonilha, Erin L Reedy, Janina Wilmskoetter and 2 others
PMID 38265506WHAT IT FOUND
Lowering adult MBSS fluoroscopy pulse rate to 15 pps or less made swallow ratings less accurate and less reliable across all bolus types.
Clinicians should keep MBSS pulse rates above 15 pps.
Key findings
01Reducing pulse rate had a statistically significant impact on 8 components of the MBSImP and on PAS scores.
02At 15 pps, 8 of 17 MBSImP components were moderately or severely impacted; at 7.5 pps, 12 of 17 were moderately or severely impacted; at 4 pps, 16 of 17 were moderately or severely impacted.
03When pulse rate was reduced from 30 to 15 pps, the impact was seen across all bolus/trial types, and thinner liquids were more impacted than thicker ones.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study analyzed existing adult MBSS recordings and simulated lower pulse rates by removing and repeating frames, rather than acquiring new MBSSs at those pulse rates. The data were collected retrospectively from a single academic medical center, so they may not represent all clinical settings. The outcomes were rater scores and agreement, not patient swallowing outcomes, treatment decisions, diet recommendations, or safety events. The paper discusses children by inference from adult swallow timing and vocal tract length, not by direct pediatric study. Radiation exposure and cancer risk figures are cited from prior work, not measured in this study. All original MBSSs were recorded at 30 pps, and the study used MBSImP and PAS ratings by trained SLPs, so results may not apply to other protocols or less experienced raters.
Declared interests
The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute on Deafness and Other Communication Disorders. The supplied text does not report other conflicts of interest.
The easy way to misread this
Do not conclude that lowering the pulse rate is a harmless way to reduce radiation exposure. The study found that reducing pulse rate to 15 pps or below degraded MBSImP and PAS ratings across all bolus types.