Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia : Results from a Prospective Exploratory Study

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Steele , C M , Mukherjee , R , Kortelainen , J M , Polonen , H , Jedwab , M , Brady , S L , Theimer , K B , Langmore , S , Riquelme , L F , Swigert , N B , Bath , P M , Goldstein , L B , Hughes , R L , Leifer , D , Lees , K R , Meretoja , A & Muehlemann , N 2019 , ' Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia : Results from a Prospective Exploratory Study ' , Dysphagia , vol. 34 , no. 5 , pp. 698-707 . https://doi.org/10.1007/s00455-018-09974-5

Title: Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia : Results from a Prospective Exploratory Study
Author: Steele, Catriona M.; Mukherjee, Rajat; Kortelainen, Juha M.; Polonen, Harri; Jedwab, Michael; Brady, Susan L.; Theimer, Kayla Brinkman; Langmore, Susan; Riquelme, Luis F.; Swigert, Nancy B.; Bath, Philip M.; Goldstein, Larry B.; Hughes, Richard L.; Leifer, Dana; Lees, Kennedy R.; Meretoja, Atte; Muehlemann, Natalia
Contributor: University of Helsinki, HUS Neurocenter
Date: 2019-10
Language: eng
Number of pages: 10
Belongs to series: Dysphagia
ISSN: 0179-051X
URI: http://hdl.handle.net/10138/305559
Abstract: Oropharyngeal dysphagia is prevalent in several at-risk populations, including post-stroke patients, patients in intensive care and the elderly. Dysphagia contributes to longer hospital stays and poor outcomes, including pneumonia. Early identification of dysphagia is recommended as part of the evaluation of at-risk patients, but available bedside screening tools perform inconsistently. In this study, we developed algorithms to detect swallowing impairment using a novel accelerometer-based dysphagia detection system (DDS). A sample of 344 individuals was enrolled across seven sites in the United States. Dual-axis accelerometry signals were collected prospectively with simultaneous videofluoroscopy (VFSS) during swallows of liquid barium stimuli in thin, mildly, moderately and extremely thick consistencies. Signal processing classifiers were trained using linear discriminant analysis and 10,000 random training-test data splits. The primary objective was to develop an algorithm to detect impaired swallowing safety with thin liquids with an area under receiver operating characteristic curve (AUC) > 80% compared to the VFSS reference standard. Impaired swallowing safety was identified in 7.2% of the thin liquid boluses collected. At least one unsafe thin liquid bolus was found in 19.7% of participants, but participants did not exhibit impaired safety consistently. The DDS classifier algorithms identified participants with impaired thin liquid swallowing safety with a mean AUC of 81.5%, (sensitivity 90.4%, specificity 60.0%). Thicker consistencies were effective for reducing the frequency of penetration-aspiration. This DDS reached targeted performance goals in detecting impaired swallowing safety with thin liquids. Simultaneous measures by DDS and VFSS, as performed here, will be used for future validation studies.
Subject: Deglutition
Deglutition disorders
Dysphagia
Swallowing
Screening
Devices
NEUROLOGICAL DISORDERS
EARLY MANAGEMENT
2018 GUIDELINES
ASPIRATION
STROKE
ACCURACY
VISCOSITY
PROTOCOL
RESIDUE
UTILITY
3125 Otorhinolaryngology, ophthalmology
3124 Neurology and psychiatry
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