Assessing Penetration and Aspiration: How Do Videofluoroscopy and Fiberoptic Endoscopic Evaluation of Swallowing Compare?
Objectives/Hypothesis: We aimed to investigate whether the type of dysphagia examination (fiberoptic endoscopic evaluation of swallowing (FEES) or videofluo- roscopy) influences the scoring of penetration and aspiration. Study Design: Prospective, single-blind study. Methods: Fifteen dysphagic participants were re- cruited and underwent one FEES and one videofluoros- copy examination, performed and recorded simulta- neously. Fifteen independent raters from 12 centers scored penetration and aspiration from recordings using the Penetration Aspiration Scale. Raters were blind to participant details, the pairing of the FEES and video- fluoroscopy recordings, and the other raters' scores. Inter- rater and intrarater reliability were analyzed using weighted kappa. Results: The Penetration Aspiration Scale scores were significantly higher for the FEES recordings than for the videofluoroscopy recordings (ANOVA P.001). The mean difference between the FEES and videofluoros- copy penetration aspiration scores for the same swallows was 1.15 points. Interrater and intrarater reliability ranged from 0.64 to 0.79 (weighted kappa). Conclusions: Penetration aspiration is perceived to be greater (more severe) from FEES than videofluoros- copy images. The clinical implications are discussed.
, vol. 117, no. 10, pp. 1723-1727, 2007