Oesophageal screening in videofluoroscopic swallow studies: Perspectives from the multidisciplinary dysphagia team to refine the clinical pathway.
Kellie McCarthy, Emma Finch, Anna Miles
PMID 39977716WHAT IT FOUND
Dysphagia teams valued oesophageal screening in VFSS but found it limited by positioning, unclear normal transit, inefficient gastroenterology referral pathways, and variable treatment knowledge.
They wanted patient symptoms, preferences and agreed team roles to drive decisions.
Key findings
01All five health professions interviewed reported that oesophageal screening in VFSS adds useful diagnostic information and is time and resource efficient.
02Teams reported variable perceptions of normal versus abnormal oesophageal transit and called for clearer gastroenterology referral criteria.
03All five health professions interviewed reported that patient history, current medical status, reported symptoms and treatment preferences should guide dysphagia decisions.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was done at one Australian hospital, so its themes may not apply to services without radiologists present during VFSS or with different referral systems. Participants were health professionals who worked in or referred to VFSS and likely had an interest in dysphagia, so their views may not represent all clinicians. The facilitator was an SLT working in the VFSS clinic and known to some participants, which may have influenced what people said. Patients and caregivers were not interviewed, although clinicians repeatedly said patient context and preferences should guide decisions. The refined clinical pathway was developed and reviewed locally, but not trialled with patients or evaluated for outcomes.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that oesophageal screening or the refined pathway improves dysphagia outcomes. The study reports clinicians' perspectives and a locally reviewed pathway; it did not test the pathway in patients or measure swallowing outcomes.