SLPOtherDysphagia2026

Preliminary Validation of Dynamic Imaging Grade of Swallowing Toxicity (DIGESTV2) for Characterizing Swallow Safety and Efficiency in Post-Stroke Populations.

Brittany N Krekeler, Anna Hopkins, Claudia Vollman and 6 others

PMID 40810807

WHAT IT FOUND

The DIGEST V2 swallowing tool tracks pharyngeal residue and aspiration well in post-stroke patients.

However, it fails to capture oral-phase deficits and shows poor reliability for grading efficiency. Use it to monitor pharyngeal safety, but do not rely on it to assess oral function.

Key findings

01DIGEST V2 grades correlate significantly with MBSImP Pharyngeal Total scores and Functional Oral Intake Scale (FOIS) scores, indicating validity for pharyngeal impairment and overall intake.

02DIGEST V2 grades show no association with MBSImP Oral Total scores, meaning the tool does not reflect oral-phase swallowing deficits.

03Inter-rater reliability for DIGEST V2 efficiency grades was only moderate, and the tool failed to distinguish between adjacent mild-to-moderate and moderate-to-severe grades.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The sample was small (88 patients) and had an uneven distribution of DIGEST grades, with very few patients at Grade 2 and only one at Grade 4. Many patients skipped the cracker bolus trial due to severe oral inefficiencies, which prevented the derivation of moderate efficiency grades. The study used the MBSImP bolus protocol, which differs from the original DIGEST validation protocol (e.g., fewer thin liquid trials), potentially affecting grade distribution. The retrospective design limited data on exact time post-stroke, lesion location, and stroke severity.

Declared interests

None reported in the provided text.

The easy way to misread this

Do not use DIGEST V2 to assess oral-phase swallowing function. The study found no correlation between DIGEST grades and MBSImP Oral Total scores, meaning the tool is blind to oral deficits common in post-stroke patients.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →