Preliminary psychometric performance of the Neonatal Feeding Assessment Scale.
Mari Viviers, Alta Kritzinger, Bart Vinck and 1 others
PMID 28155281WHAT IT FOUND
In 20 high-risk neonates, a new feeding assessment flagged all babies with oral-pharyngeal swallowing problems on modified barium swallow, but also flagged three babies whose modified barium swallow did not show this problem.
It looks promising for clinical assessment, not proof it works.
Key findings
01The NFAS diagnosed oral-pharyngeal dysphagia in nine of 20 neonates.
02Against modified barium swallow, the NFAS identified all six neonates with oral-pharyngeal dysphagia, but three were false positives; sensitivity was 100% and specificity 78.6%.
03Two raters agreed on the NFAS diagnosis in nine of ten cases, and overall agreement with modified barium swallow diagnosis was 85%.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 20 neonates were tested, all in one South African neonatal intensive care unit and selected for feeding risk, so the results may not apply to other neonates or settings. The sample was too small to determine the true prevalence of oral-pharyngeal dysphagia or how much each NFAS section contributes to diagnosis. Some physiological and state items could not be scored because monitors were not available, which may have distorted section scores. Inter-rater reliability was checked on only 10 infants by two raters, and one section showed only slight agreement. The study did not test what happens when the same infant is assessed more than once.
The easy way to misread this
Do not read the 100% sensitivity as proof the NFAS works for all neonates. It was tested in only 20 high-risk infants, and three babies with no oral-pharyngeal dysphagia on modified barium swallow were still flagged.