SLPOtherDysphagia2018

Rethinking Residue: Determining the Perceptual Continuum of Residue on FEES to Enable Better Measurement.

Jessica M Pisegna, Asako Kaneoka, Rebecca Leonard and 1 others

PMID 28856436

WHAT IT FOUND

Clinicians' 100-mm line ratings and none-to-severe category ratings of residue on swallowing endoscopy videos moved together, but unevenly.

Category steps did not represent equal amounts of residue, so line ratings may better reflect severity.

Key findings

01Line ratings and category ratings correlated strongly: r=0.85 for thin liquid, r=0.92 for applesauce, and r=0.90 for cracker.

02A curved model fit better than a straight-line model, and a more complex curved model did not improve fit.

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 how clinicians rate videos, not whether residue amount or rating method affects patient swallowing outcomes. Videos were selected to include examples at each severity for each consistency, so they may not reflect the range seen in routine FEES. No operational definitions were given for residue categories, so clinicians may have used different internal meanings for mild, moderate, and severe. The study did not separate residue amount from residue location, and location may change clinical meaning. Three participants had only one day between sessions, which may have affected ratings. The sample was 33 clinicians, with limited experience range and no patient-level outcomes.

Declared interests

No author conflicts of interest were reported in the supplied text. The article is tagged as supported by NIH extramural and non-U.S. government research funding.

The easy way to misread this

Do not conclude that using a 100-mm line improves FEES safety or patient care. The study showed only that line and category ratings relate unevenly on videos; it did not test clinical outcomes.

Read it on PubMed →