Cook, LM; (2005) Clinical audit of dysphagia practices: Is the management of clients altered following videofluoroscopic examination? Doctoral thesis , UCL (University College London).

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Abstract

The videofluoroscopic procedure (VFSS) is currently considered the "gold standard" in assessing, diagnosing and informing the management of clients with dysphagia. The purpose of this investigation was to evaluate the clinical utility of the VFSS and whether it altered management of dysphagic clients. The present study replicated and extended previous research by Martin-Harris, Logemann, McMahon, Schleicher and Sandidge (2000). Files from one hundred inpatients with neurological disorders who had undergone a VFSS at the National Hospital of Neurology and Neurosurgery were reviewed. Data was obtained according to six variables dysphagia severity ratings, referral onwards, mode of intake alterations, diet consistency alterations, compensation strategies and swallowing therapy that improved the swallow. As found by Martin-Harris et al. (2000), over three quarters (82%) of the sample experienced change in at least one of the variables, with the majority experiencing change in more than two variables. The VFSS resulted in significant alterations in severity ratings, mode of intake, diet consistencies, in addition to identifying effective compensation strategies. However, no significant changes were found following VFSS in referral onwards or the implementation of swallowing therapy. These findings are discussed with reference to their external validity in light of the current limitations of the VFSS.

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