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Visuoperceptual Analysis of the Videofluoroscopic Study of Swallowing: An International Delphi Study

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Abstract

Introduction

The Videofluoroscopic Swallow Study (VFSS) is a commonly used dysphagia assessment that is routinely analysed visuoperceptually. However, no consensus exists regarding which visuoperceptual measures should be used to analyse VFSSs. Current visuoperceptual measures for VFSSs are limited by poor quality and incomplete or indeterminate psychometric properties.

Objective

This study aimed to establish the content validity for a new visuoperceptual VFSS measure for oropharyngeal dysphagia in adults, by identifying relevant domains of the construct and generating items and corresponding response scales.

Methods

Consensus among experts in dysphagia and VFSS from over 20 countries was achieved across three rounds of anonymous online surveys, using the Delphi technique. Participants judged relevance and comprehensiveness of definitions of visuoperceptual domains of VFSS and the relevance of various domains to the overall construct. After reaching consensus on definitions of relevant domains, consensus on items were established using the same process.

Results

Participants achieved consensus on definitions of 32 domains recommended for analysis, and at least one item per domain (range 1–4). Domains selected by participants included both those which occur in existing measures and domains which have not been included in any measures to date. This study will form the basis for content validity of a new measure for VFSS.

Conclusions

This first phase of developing a visuoperceptual measure of VFSS resulted in the identification of 32 domains and 60 items for oropharyngeal dysphagia. Developers can now advance to the next phase of measure construction; prototype development and psychometric testing.

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Acknowledgements

Authors would like to acknowledge and thank the experts who voluntarily participated in all three rounds of the Delphi studies and shared their wealth of knowledge: The authors wish to gratefully acknowledge Professor Catriona Steele, for her generous contribution of her times and expertise in revising and formulating items and definitions for domains.

Funding

Funding was provided by Curtin University of Technology.

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Authors and Affiliations

  1. School of Occupational Therapy, Speech Pathology and Social Work, Curtin University, Kent Street, Bentley, 6102, WA, Australia

    Katina Swan, Reinie Cordier & Renée Speyer

  2. Northumbria University, Room B014, Coach Lane Campus, Newcastle upon Tyne, NE7 7XA, United Kingdom

    Reinie Cordier

  3. Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University – Peninsula Campus, Frankston, 3800, VIC, Australia

    Ted Brown

  4. Department of Special Needs Education, University of Oslo, P.O. Box 1072 Blindern, Oslo, 0316, Norway

    Renée Speyer

  5. Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Rapenburg 70, Leiden, 2311 EZ, The Netherlands

    Renée Speyer

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  1. Katina Swan
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  2. Reinie Cordier
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  3. Ted Brown
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  4. Renée Speyer
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Correspondence to Katina Swan.

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The first author completed this study as part of the requirements for the completion of a PhD under supervision of Reinie Cordier, Ted Brown and Renée Speyer. The authors wish to acknowledge Curtin University and the Australian Federal Government for the Curtin University Postgraduate Scholarship (CUPS) and the Australian Postgraduate Award (APA).

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Swan, K., Cordier, R., Brown, T. et al. Visuoperceptual Analysis of the Videofluoroscopic Study of Swallowing: An International Delphi Study. Dysphagia 36, 595–613 (2021). https://doi.org/10.1007/s00455-020-10174-3

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