Relationship between International Dysphagia Diet Standardisation Initiative Flow Test and Consistometric Measures for Consistency Classification: An Examination of Thickened Liquids Prepared Using Starch-Based and Xanthan Gum-Based Thickening Agents.
Mingyue Xiong, Nelson Ng, Brian Siu and 1 others
PMID 39043153WHAT IT FOUND
For water thickened with starch or xanthan gum, IDDSI syringe readings and Bostwick distances moved together.
Starch followed a straight-line equation; xanthan gum curved. Use the equations only for IDDSI levels 1 to 3.
Key findings
01IDDSI Flow Test readings and Bostwick distances were significantly correlated for both thickeners, with r = -0.9812 for starch and r = -0.9653 for xanthan gum.
02Starch-based liquids followed a linear relationship, and xanthan gum-based liquids followed a quadratic relationship.
03The equations can validly estimate consistometric measures only for IDDSI levels 1, 2, and 3.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study tested only water with ThickenUp and ThickenUp Clear, so it does not show how other beverages, thickeners, temperatures, acidity, or textures behave. The Bostwick consistometer could not measure thin liquids because they flowed farther than 24 cm in 30 s. The IDDSI Flow Test could not measure extremely thick liquids because they stayed in the syringe. The equations were valid only for IDDSI levels 1, 2, and 3. The study used limited data and only linear and quadratic models. No patients were tested, so it does not show whether these conversions improve swallowing safety.
Declared interests
The authors declared no conflicts of interest. The project was funded by the Education Faculty Research Fund, Faculty of Education, University of Hong Kong.
The easy way to misread this
Do not assume the equations can classify all thickened liquids safely. They were tested only for water-based samples at about 25°C, only for IDDSI levels 1, 2, and 3, and only for ThickenUp and ThickenUp Clear. The paper did not test patients or swallowing safety.