Identification of Phenotypic Patterns of Dysphagia: A Proof of Concept Study Purpose The purpose of the current project was to explore the feasibility for subtyping dysphagia traits or patterns of scores in a subset of data from the Modified Barium Swallow Impairment Profile global registry in patients referred to videofluoroscopic swallowing studies across 5 common medical categories: (a) cardiothoracic, (b) gastroenterology, ... Research Article
Research Article  |   August 06, 2018
Identification of Phenotypic Patterns of Dysphagia: A Proof of Concept Study
 
Author Affiliations & Notes
  • Kendrea L. (Focht) Garand
    Department of Speech Pathology & Audiology, University of South Alabama, Mobile
  • Kent E. Armeson
    Biostatistics Shared Resource, Hollings Cancer Center, Medical University of South Carolina, Charleston
  • Elizabeth G. Hill
    Department of Public Health Sciences, Medical University of South Carolina, Charleston
  • Bonnie Martin-Harris
    School of Communication, Northwestern University, Evanston, IL
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Kendrea L. (Focht) Garand: garand@southalabama.edu
  • Editor-in-Chief: Krista Wilkinson
    Editor-in-Chief: Krista Wilkinson×
  • Editor: Julie Barkmeier-Kraemer
    Editor: Julie Barkmeier-Kraemer×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Special Populations / Genetic & Congenital Disorders / Research Articles
Research Article   |   August 06, 2018
Identification of Phenotypic Patterns of Dysphagia: A Proof of Concept Study
American Journal of Speech-Language Pathology, August 2018, Vol. 27, 988-995. doi:10.1044/2018_AJSLP-17-0173
History: Received October 19, 2017 , Revised January 2, 2018 , Accepted February 12, 2018
 
American Journal of Speech-Language Pathology, August 2018, Vol. 27, 988-995. doi:10.1044/2018_AJSLP-17-0173
History: Received October 19, 2017; Revised January 2, 2018; Accepted February 12, 2018

Purpose The purpose of the current project was to explore the feasibility for subtyping dysphagia traits or patterns of scores in a subset of data from the Modified Barium Swallow Impairment Profile global registry in patients referred to videofluoroscopic swallowing studies across 5 common medical categories: (a) cardiothoracic, (b) gastroenterology, (c) head and neck cancer, (d) neurology, and (e) pulmonary.

Method Videofluoroscopic swallowing study imaging and Modified Barium Swallow Impairment Profile metrics were used to evaluate 235 patients with dysphagia grouped into 1 of the 5 categories. Two summative domain scores (oral total [OT] and pharyngeal total [PT]) and 17 component scores were tested for differences among the categories.

Results When compared with the gastroenterology category, significantly higher OT/PT scores were observed in neurology and pulmonary categories (all p values < .05). Four oral and 6 pharyngeal domain components significantly differed across medical categories: tongue control during bolus hold (all p values < .04).

Conclusions The results of this feasibility study demonstrate that summative scores of swallowing physiology alone are not sufficiently robust to distinguish subtypes of dysphagia in broad, heterogeneous medical categories. Using OT/PT as subtypes only separated gastroenterology from the other categories, suggesting overlap in OT/PT scores between the latter categories.

Acknowledgments
The contents of this publication were developed under grants from the National Institutes of Health under Grant K23DC005764 (PI: Martin-Harris) and Grant 1K24DC12801 (PI: Martin-Harris).
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