Journal of the Formosan Medical Association = Taiwan yi zhi · 2025
Repetitive saliva swallowing test: Performance in aspiration prediction.
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Chen Yu-Chung, Li Chia-Ing, Tsou Yung-An, Lai Yu-Hsuan, Meng Nai-Hsin
Аннотация
BACKGROUND/PURPOSE: This retrospective study evaluates the performance characteristics of the Repetitive Saliva Swallowing Test (RSST), a widely used dysphagia screening tool known for its simplicity, safety, and high sensitivity in predicting aspiration during modified barium swallow studies (MBSS).
METHODS: We analyzed data from 246 patients (197 men, 49 women; median age 62 years) who underwent MBSS between August 2021 and January 2023 at a medical center. The patients were grouped into head and neck cancer (n = 164), neurological disease (n = 47), and other conditions (n = 35). RSST was performed immediately before MBSS, recording the number of swallows in 30s. MBSS was conducted following the Modified Barium Swallow Impairment Profile™ protocol, evaluating 17 physiological swallowing parameters and generating Oral and Pharyngeal Impairment Scores. Swallowing safety were assessed using the Penetration-Aspiration Scale, while transit times were measured for thin barium boluses.
RESULTS: Using RSST count ≤2 as the cutoff, sensitivity for detecting aspiration during MBSS was 35.5 %, specificity 92.4 %, and accuracy 78.1 %. Sensitivity was the lowest in the cancer group (25.0 %) and the highest in other conditions (50.0 %). Optimal cutoffs were identified at RSST ≤3, ≤4, and ≤2, with an area under the receiver operating characteristic curve of 0.72.
CONCLUSION: Although RSST demonstrates low sensitivity for aspiration detection, its high specificity, simplicity, and safety make it suitable for large-scale screening in populations with relatively low dysphagia prevalence.
METHODS: We analyzed data from 246 patients (197 men, 49 women; median age 62 years) who underwent MBSS between August 2021 and January 2023 at a medical center. The patients were grouped into head and neck cancer (n = 164), neurological disease (n = 47), and other conditions (n = 35). RSST was performed immediately before MBSS, recording the number of swallows in 30s. MBSS was conducted following the Modified Barium Swallow Impairment Profile™ protocol, evaluating 17 physiological swallowing parameters and generating Oral and Pharyngeal Impairment Scores. Swallowing safety were assessed using the Penetration-Aspiration Scale, while transit times were measured for thin barium boluses.
RESULTS: Using RSST count ≤2 as the cutoff, sensitivity for detecting aspiration during MBSS was 35.5 %, specificity 92.4 %, and accuracy 78.1 %. Sensitivity was the lowest in the cancer group (25.0 %) and the highest in other conditions (50.0 %). Optimal cutoffs were identified at RSST ≤3, ≤4, and ≤2, with an area under the receiver operating characteristic curve of 0.72.
CONCLUSION: Although RSST demonstrates low sensitivity for aspiration detection, its high specificity, simplicity, and safety make it suitable for large-scale screening in populations with relatively low dysphagia prevalence.