scholarly journals Evaluation of the Modified Barium Swallow Study Conducted With and Without Radiologist Supervision: A Pre- and Post-Observational Study

2021 ◽  
pp. 084653712110206
Author(s):  
Luhe Yang ◽  
David Leswick ◽  
Michael Butler ◽  
Tasha Ellchuk
Keyword(s):  
Tertiary Care ◽  
Fluoroscopy Time ◽  
Barium Swallow ◽  
Final Report ◽  
Care Hospital ◽  
Modified Barium Swallow ◽  
Study Duration ◽  
Improved Performance ◽  
Assess Quality ◽  
Modified Barium Swallow Study

Purpose: Assess quality metrics of modified barium swallow studies (MBSS) with and without a radiologist present during the procedure. Methods: Retrospective review of MBSS performed on adult inpatients at a tertiary care hospital 6-months pre- and post-institutional change from having to not having a radiologist present during the examination. Factors assessed included: fluoroscopy time; study duration; number of cine loops; number of images; efficiency of collimation (using a 5-point scoring system); time to final report; radiologist-speech language pathologist report disagreement; and recalls for inadequate studies. Statistical analysis was via Welch’s t-test and a test of proportions for continuous and count data under the normal approximation. Results: 106 and 119 MBSS were analyzed from the radiologist present and radiologist absent periods, respectively. No statistically significant differences were found for: average fluoroscopy time (116.1 s vs. 126.9 s; P = 0.161); study duration (400.4 s vs. 417.3 s; P = 0.453); number of cine loops (9.3 vs. 10.2; P = 0.075); number of images (620.5 vs. 581.1; P = 0.350); or report disagreement. There was improved performance without the radiologist present for collimation (1.92 vs. 1.43; P = 0.003) and fewer non-diagnostic images (6.5 vs. 4.5; P = 0.001). Time to final report was longer with the radiologist absent due to more reports with significant delays. There were no repeated studies because of inadequate technique in either group. Conclusion: MBSS performed by technologists without radiologist supervision is not inferior to those performed with radiologist supervision on multiple performance measures. This supports technologist operated MBSS without radiologist supervision, while acknowledging a need to further address radiologist report time delay.

scholarly journals Supervision and monitoring to assess quality of outreach immunization sessions in a rural area using a checklist

2020 ◽  
Vol 7 (5) ◽  
pp. 1950
Author(s):  
Ambika R. Bhaskar ◽  
Mridula Solanki
Keyword(s):  
Tertiary Care ◽  
Immunization Coverage ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Immunization Services ◽  
Timely Fashion ◽  
Assess Quality

Background: Immunization is one of the most cost-effective interventions to prevent the suffering that comes from avoidable sickness, disability and death. Outreach immunization services ensure that immunization is available to children who are unable to access a general practice in a timely fashion for their immunization events. Effective supervision and monitoring will help in improving quality and coverage of immunization.Methods: This was an observational cross-sectional study conducted in the rural field practice area of a tertiary care hospital. 50 outreach sessions held in various outdoor places including Anganwadi were supervised and monitored using checklist. 110 mothers and 20 stakeholders were interviewed. Immunization records were assessed.Results: Outreach immunization sessions were found to be of good quality. 89% children were fully immunized. ANMs and ASHAs were of the opinion that outreach session has significantly raised immunization coverage. 75.4% mothers had knowledge about services provided by outreach sessions.Conclusions: There was increase in immunization coverage due to outreach sessions. There is need for adequate supervision on safety injection practices and regular timely incentive to ASHA.

Retained Esophageal Contrast on Modified Barium Swallow Study Predicts Abnormal High Resolution Esophageal Manometry

2017 ◽  
Vol 152 (5) ◽  
pp. S697
Author(s):  
David Lin ◽  
Jeremy Wang ◽  
Andrew A. Erman ◽  
Dinesh Chhetri ◽  
Conklin Jeffrey
Keyword(s):  
High Resolution ◽  
Esophageal Manometry ◽  
Barium Swallow ◽  
Modified Barium Swallow ◽  
Swallow Study ◽  
Modified Barium Swallow Study

scholarly journals Aging Effects on Esophageal Transit Time in the Upright Position During Videofluoroscopy

2020 ◽  
Vol 129 (6) ◽  
pp. 618-624
Author(s):  
Kendrea L. (Focht) Garand ◽  
Lindsey Culp ◽  
Bin Wang ◽  
Kate Davidson ◽  
Bonnie Martin-Harris
Keyword(s):  
Age Groups ◽  
Normative Values ◽  
Barium Swallow ◽  
Aging Effects ◽  
Esophageal Function ◽  
Modified Barium Swallow ◽  
Esophageal Transit ◽  
Esophageal Clearance ◽  
Age Related ◽  
Modified Barium Swallow Study

Objectives: The purpose of this study was to examine age-related effects on esophageal transit times (ETT) among healthy adult participants. Methods: A total of 175 healthy, non-dysphagic participants underwent a modified barium swallow study (MBSS), and ETT was recorded for two standardized swallowing tasks. Differences across age groups were determined using Kruskal–Wallis test. Relationships between an Esophageal Clearance (Modified Barium Swallow Impairment Profile Component 17) score and ETT were also explored. Results: No significant differences were observed in ETT across age groups for nectar-thickened liquid ( P = .335) or pudding ( P = .231) consistencies. No significant differences were observed between males and females in ETT for either the nectar ( P = .112) or pudding trial ( P = .817). For nectar, the mean ETT for patients with Component 17 scores of 2 or greater were significantly higher than that of participants with a score of 0 ( P < .0001). For pudding, participants with a score >0 demonstrated significantly higher mean ETT compared to participants with a score of 0 (with P = .0008 and P < .0001, respectively). Conclusion: Study findings failed to support age-related or sex-related differences in ETT for two standardized swallowing tasks administered during a MBSS in healthy individuals. The normative values following a standardized protocol in this study provide guidance in clinical interpretation of esophageal function.

scholarly journals Identification of Swallowing Tasks From a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment

2017 ◽  
Vol 60 (7) ◽  
pp. 1855-1863 ◽  
Author(s):  
R. Jordan Hazelwood ◽  
Kent E. Armeson ◽  
Elizabeth G. Hill ◽  
Heather Shaw Bonilha ◽  
Bonnie Martin-Harris
Keyword(s):  
Generalized Estimating Equations ◽  
High Probability ◽  
Secondary Data ◽  
Barium Swallow ◽  
Oral Clearance ◽  
Airway Protection ◽  
Modified Barium Swallow ◽  
Severe Impairment ◽  
Swallow Study ◽  
Modified Barium Swallow Study

Purpose The purpose of this study was to identify which swallowing task(s) yielded the worst performance during a standardized modified barium swallow study (MBSS) in order to optimize the detection of swallowing impairment. Method This secondary data analysis of adult MBSSs estimated the probability of each swallowing task yielding the derived Modified Barium Swallow Impairment Profile (MBSImP™©; Martin-Harris et al., 2008) Overall Impression (OI; worst) scores using generalized estimating equations. The range of probabilities across swallowing tasks was calculated to discern which swallowing task(s) yielded the worst performance. Results Large-volume, thin-liquid swallowing tasks had the highest probabilities of yielding the OI scores for oral containment and airway protection. The cookie swallowing task was most likely to yield OI scores for oral clearance. Several swallowing tasks had nearly equal probabilities (≤ .20) of yielding the OI score. Conclusions The MBSS must represent impairment while requiring boluses that challenge the swallowing system. No single swallowing task had a sufficiently high probability to yield the identification of the worst score for each physiological component. Omission of swallowing tasks will likely fail to capture the most severe impairment for physiological components critical for safe and efficient swallowing. Results provide further support for standardized, well-tested protocols during MBSS.

Use of modified barium swallow study to measure posterior airway space in obstructive sleep apnea

2016 ◽  
Vol 136 (6) ◽  
pp. 592-597 ◽  
Author(s):  
Tyler Crosby ◽  
Jeff Phillips ◽  
Alberto Carbo ◽  
Kelley Babcock ◽  
Cherie-Ann Nathan
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Barium Swallow ◽  
Modified Barium Swallow ◽  
Posterior Airway Space ◽  
Obstructive Sleep ◽  
Swallow Study ◽  
Modified Barium Swallow Study

The prevalence and effects of aspiration among neonates at the time of discharge

2017 ◽  
Vol 27 (7) ◽  
pp. 1241-1247 ◽  
Author(s):  
Emily Karsch ◽  
Sharon Y. Irving ◽  
Brandon S. Aylward ◽  
William T. Mahle
Keyword(s):  
Cardiac Surgery ◽  
Patient Population ◽  
Heart Surgery ◽  
Single Ventricle ◽  
Barium Swallow ◽  
Modified Barium Swallow ◽  
Study Results ◽  
Neonatal Cardiac Surgery ◽  
Swallow Study ◽  
Modified Barium Swallow Study

AbstractBackgroundNeonates undergoing heart surgery for CHD are at risk for postoperative gastrointestinal complications and aspiration events. There are limited data regarding the prevalence of aspiration after neonatal cardiothoracic surgery; thus, the effects of aspiration events on this patient population are not well understood. This retrospective chart review examined the prevalence and effects of aspiration among neonates who had undergone cardiac surgery at the time of their discharge.IntroductionThis study examined the prevalence of aspiration among neonates who had undergone cardiac surgery. Demographic data regarding these patients were analysed in order to determine risk factors for postoperative aspiration. Post-discharge feeding routes and therapeutic interventions were extracted to examine the time spent using alternate feeding routes because of aspiration risk or poor caloric intake. Modified barium swallow study results were used to evaluate the effectiveness of the test as a diagnostic tool.Materials and methodsA retrospective study was undertaken of neonates who had undergone heart surgery from July, 2013 to January, 2014. Data describing patient demographics, feeding methods, and follow-up visits were recorded and compared using a χ2 test for goodness of fit and a Kaplan–Meier graph.ResultsThe patient population included 62 infants – 36 of whom were male, and 10 who were born with single-ventricle circulation. The median age at surgery was 6 days (interquartile range=4 to 10 days). Modified barium swallow study results showed that 46% of patients (n=29) aspirated or were at risk for aspiration, as indicated by laryngeal penetration. In addition, 48% (n=10) of subjects with a negative barium swallow or no swallow study demonstrated clinical aspiration events. Tube feedings were required by 66% (n=41) of the participants. The median time spent on tube feeds, whether in combination with oral feeds or exclusive use of a nasogastric or gastric tube, was 54 days; 44% (n=27) of patients received tube feedings for more than 120 days. Premature infants were significantly more likely to have aspiration events than infants delivered at full gestational age (OR p=0.002). Infants with single-ventricle circulation spent a longer time on tube feeds (median=95 days) than infants with two-ventricle defects (median=44 days); the type of cardiac defect was independent of prevalence of an aspiration event.ConclusionsAspiration is common following neonatal cardiac surgery. The modified barium swallow study is often used to identify aspiration events and to determine an infant’s risk for aspirating. This leads to a high proportion of infants who require tube feedings following neonatal cardiac surgery.

scholarly journals Factors Influencing Initiation of Pharyngeal Swallow in Healthy Adults

2020 ◽  
Vol 29 (4) ◽  
pp. 1956-1964
Author(s):  
Ankita M. Bhutada ◽  
Rajarshi Dey ◽  
Bonnie Martin-Harris ◽  
Kendrea L. (Focht) Garand
Keyword(s):  
Healthy Adults ◽  
Barium Swallow ◽  
Large Variability ◽  
Modified Barium Swallow ◽  
Factors Influencing ◽  
Volume Viscosity ◽  
Pharyngeal Swallow ◽  
Swallow Study ◽  
Dysphagic Patients ◽  
Modified Barium Swallow Study

Purpose The purpose of this study was to investigate factors influencing the initiation of pharyngeal swallow (IPS) in healthy, nondysphagic adults. Method A total of 195 healthy participants ranging in age from 21 to 89 years participated in a modified barium swallow study. IPS was quantified using the Modified Barium Swallow Impairment Profile standardized scoring system across nine swallowing tasks observed in the lateral viewing plane for each participant. Results Large variability for bolus head location at time of hyoid burst (IPS) was observed within this healthy cohort, ranging from the ramus of the mandible to the pyriform sinuses. Significant effects of bolus volume, viscosity, sex, and race were also observed. Conclusion Study findings indicate that IPS is variable in healthy adults and influenced by volume, viscosity, sex, and race. Thus, variability in IPS may be considered typical in otherwise nondysphagic adults. The clinical significance of high Modified Barium Swallow Impairment Profile IPS scores in dysphagic patients, therefore, must be considered within the context of other swallowing impairments. Supplemental Material https://doi.org/10.23641/asha.12735935

The Modified Barium Swallow Impairment Profile (MBSImP): A New Standard Physiologic Approach to Swallowing Assessment and Targeted Treatment

2009 ◽  
Vol 18 (4) ◽  
pp. 117-122 ◽  
Author(s):  
John Sandidge
Keyword(s):  
Objective Assessment ◽  
Life Quality ◽  
Communication Disorders ◽  
Barium Swallow ◽  
Validity And Reliability ◽  
Modified Barium Swallow ◽  
Speech Language Pathologist ◽  
Under Construction ◽  
Modified Barium Swallow Study ◽  
Swallowing Assessment

Abstract One of the most critical roles of a speech-language pathologist (SLP) is making decisions from a swallowing assessment about life sustaining and life quality issues such as the ability to continue to eat and drink. The optimal swallowing assessment requires recognizing subtle variations in the physiologic components and events that comprise an intact, healthy swallowing mechanism. No voluntary standard currently exists for swallowing evaluation terminology, measurement, or reporting. Bonnie Martin-Harris, a practicing clinician and researcher, sought to evaluate if a protocol that standardized language, administration/measurement of contrast viscosities, and reporting method could be validly and reliably executed for the modified barium swallow study (MBSS). A five-year study supported by the National Institute on Deafness and Other Communication Disorders (NIDCD) rigorously tested the content and external validity and reliability of a method that resulted in developing a standardized tool, the Modified Barium Swallow Impairment Profile (MBSImP) (Martin-Harris et al., 2008). A web-based learning environment is under construction and will be available for any clinician who desires training and competence in using the MBSImP. This article provides background on development of the MBSImP, the importance and benefit of standardized, objective assessment, and detail on features and status of the MBSImP web site.

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