Reliability for detecting oropharyngeal aspiration in children using cervical auscultation

Frakking, Thuy T., Chang, Anne B., O'Grady, Kerry-Ann F., David, Michael and Weir, Kelly A. (2016) Reliability for detecting oropharyngeal aspiration in children using cervical auscultation. International Journal of Speech-Language Pathology, 19 6: 1-9. doi:10.1080/17549507.2016.1222452


Author Frakking, Thuy T.
Chang, Anne B.
O'Grady, Kerry-Ann F.
David, Michael
Weir, Kelly A.
Title Reliability for detecting oropharyngeal aspiration in children using cervical auscultation
Journal name International Journal of Speech-Language Pathology   Check publisher's open access policy
ISSN 1754-9507
1754-9515
Publication date 2016-09-29
Sub-type Article (original research)
DOI 10.1080/17549507.2016.1222452
Open Access Status Not yet assessed
Volume 19
Issue 6
Start page 1
End page 9
Total pages 9
Place of publication Abingdon, Oxfordshire, United Kingdom
Publisher Taylor & Francis
Language eng
Subject 2922 Research and Theory
2733 Otorhinolaryngology
1203 Language and Linguistics
2912 LPN and LVN
3616 Speech and Hearing
Abstract Purpose: Limited data exist that support the reproducibility of cervical auscultation (CA) use in children. This study aimed to determine the reliability of CA in detecting oropharyngeal aspiration (OPA) in children within a controlled environment. Method: This observational study included eight speech-language pathologists who rated clips of 40 normal and 40 OPA swallowing sounds on two separate occasions (i.e.160 sound clips rated by each speech-language pathologist) to comprise a total of 1280 swallow clips rated. Swallowing sound clips were collected from (1) a volunteer sample of 20 healthy children from the general community (mean 16.2 ± 10.7 months; 65% female); (2) a referred sample of 19 children with demonstrated OPA (mean 22.8 ± 25.5 months; 36.8% female), as determined on videofluoroscopic swallow studies (VFSS) using the Penetration-Aspiration Scale (PAS) (≥6 score). Result: Inter-rater reliability was very good (kappa =0.81, 95%CI 0.79–0.84). Intra-rater reliability for each rater was good to very good (kappa range 0.72–0.98). Overall sensitivity was 93.9% (95%CI 91.8–95.6) and specificity was 94.5% (95%CI 92.5–96.2). High reliability values were found for the detection of OPA versus normal swallows using CA alone. Conclusion: Future research should investigate the use of CA in a variety of clinical settings with less environmental control before CA can be advocated for use in routine clinical practice.
Formatted abstract
Purpose: Limited data exist that support the reproducibility of cervical auscultation (CA) use in children. This study aimed to determine the reliability of CA in detecting oropharyngeal aspiration (OPA) in children within a controlled environment.

Method: This observational study included eight speech-language pathologists who rated clips of 40 normal and 40 OPA swallowing sounds on two separate occasions (i.e.160 sound clips rated by each speech-language pathologist) to comprise a total of 1280 swallow clips rated. Swallowing sound clips were collected from (1) a volunteer sample of 20 healthy children from the general community (mean 16.2 ± 10.7 months; 65% female); (2) a referred sample of 19 children with demonstrated OPA (mean 22.8 ± 25.5 months; 36.8% female), as determined on videofluoroscopic swallow studies (VFSS) using the Penetration-Aspiration Scale (PAS) (≥6 score).

Result: Inter-rater reliability was very good (kappa =0.81, 95%CI 0.79–0.84). Intra-rater reliability for each rater was good to very good (kappa range 0.72–0.98). Overall sensitivity was 93.9% (95%CI 91.8–95.6) and specificity was 94.5% (95%CI 92.5–96.2). High reliability values were found for the detection of OPA versus normal swallows using CA alone.

Conclusion: Future research should investigate the use of CA in a variety of clinical settings with less environmental control before CA can be advocated for use in routine clinical practice.
Keyword Acoustics
Dysphagia
Reliability
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 1045157
1055527
1058213
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Public Health Publications
Child Health Research Centre Publications
 
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