Bedside Clinical Swallow Test and the Fiberoptic Endoscopic Evaluation of Swallow - Level of Agreement

IntroductionBedside test are important tool for evaluating aspiration during swallowing. FEES that is functional endoscopic evaluation of swallowing is a gold standard method used in evaluation of dysphagia patients. Through this study we aim to assess the sensitivity and specificity of Bedside Clinical swallow evaluation in comparison with Fiberoptic Endoscopic Evaluation of Swallowing.ObjectiveTo analyze which physiological examination amongst oro motor labial examination, lingual examination, gag reflex, coughs during or post swallow, change in voice quality and hyo-laryngeal excursion during swallow with semisolid and thin liquid consistency in the Bedside Clinical swallow evaluation is better indicator for presence or absence of aspiration.Methodology38 patients with different diagnostic entities were presented& included in the study for the assessment of swallowing difficulties as presence or absence of aspiration and possibility of weaning from nasogastric or Nasojejunal tube between March 2016 to October 2016. They were 32 (86%) males and 6 (14%) females. Aspiration correlates were assessed using bedside test (labial movement, lingual movement, gag reflex, strength of productive cough, hyo-laryngeal excursion, And post swallow changes in the quality of voice). FEES was then performed and sensitivity and specificity was compared.ResultBedside test showed 84.62% sensitivity and 100% specificity in comparison to FEES. Gag and voice quality were noted to have significant difference with value of 0.009 and 0.033 respectively.ConclusionBedside tests can be considered as an important, easy, sensitive, and specific for the detection of aspiration. Combination of gag reflex and change of voice as parameters of aspiration compared with FEES showed high sensitivity and specificity.