Swallowing assessment in patients with dysphagia: Validity and reliability of a pocket-sized ultrasound system.
Katharina Winiker, Rebecca Hammond, Paige Thomas and 2 others
PMID 35112768WHAT IT FOUND
Pocket-sized ultrasound did not agree well with videofluoroscopy for hyoid movement and thyrohyoid approximation in dysphagia patients.
Bedside iPad scanning was inconsistent between clinicians, and offline measurement from saved images was good except tongue thickness, so it should not yet guide bedside decisions.
Key findings
01Ultrasound measures of hyoid movement and thyrohyoid approximation during liquid and puree swallowing showed only weak to fair associations with videofluoroscopic measures.
02When two clinicians measured live at the bedside, reliability was moderate for hyoid excursion and thyrohyoid approximation. When one clinician measured saved images later, reliability was good for all measures except tongue thickness.
03For the same clinician, reliability between live iPad measurement and later computer measurement was moderate for hyoid excursion and tongue thickness, and good for floor of mouth muscles.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Patients were included only if one rater's review of videofluoroscopy suggested reduced hyoid movement or thyrohyoid approximation, so the sample may not represent all patients with dysphagia. The two ultrasound raters were novice users with short training, so poor bedside reliability may reflect training rather than the device alone. Some measurements were excluded because radiographic or ultrasound images were not clear enough, and one patient's ultrasound images failed to store. Online acquisition reliability was assessed in 20% of patients (n = 8), while the full sample was 43 participants. The clinician wore lead gloves during concurrent scanning, which may have made transducer placement less stable. Videofluoroscopic hyoid excursion had poor between-rater reliability, so the reference standard was not perfectly consistent. Patients after head or neck surgery were excluded, so findings do not apply to them.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not read the good offline measurement reliability as evidence that bedside ultrasound is clinically usable. In this study, live iPad acquisition showed only moderate reliability for hyoid excursion and thyrohyoid approximation, and ultrasound measures showed only weak to fair agreement with videofluoroscopy.