Dysphagia Management and Cervical Auscultation: Reliability and Validity Against FEES

Mariam Jaghbeer, Anna-Liisa Sutt and Liza Bergström DOI https://doi.org/10.1007/s00455-022-10468-8

Abstract: This study investigated the reliability and validity (sensitivity and specificity) of cervical auscultation (CA) using both swallow and pre-post swallow-respiratory sounds, as compared with Flexible Endoscopic Evaluation of Swallowing (FEES). With 103 swallow-respiratory sequences from 23 heterogenic patients, these swallows sounds were rated by eight CA-trained Speech-Language Pathologists (SLPs) to investigate: (1) if the swallow was safe (primary outcome); (2) patient dysphagia status; (3) the influence of liquid viscosity on CA accuracy (secondary outcomes). Primary outcome data showed high CA sensitivity (85.4%), and specificity (80.3%) with all consistencies for the safe measurement, with CA predictive values of >90% to accurately detect unsafe swallows. Intra-rater reliability was good (Kappa = 0.65), inter rater reliability moderate (Kappa = 0.58).