Evidence map›Paper›PMID 37669617›Full record

ArticleJournal of speech, language, and hearing research : JSLHR2023

Reference Values for Videofluoroscopic Measures of Swallowing: An Update.

Catriona M Steele, Mark T Bayley, Mary Kathryn Bohn, Victoria Higgins, Melanie Peladeau-Pigeon, Vathany Kulasingam

Registry-linked trialOpen access · hybridAbstract read
In one paragraph

Article in Journal of speech, language, and hearing research : JSLHR, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04537650 (The Pathophysiology of Swallowing Impairment in People Recovering From COVID-19), which is not on this map. Cited by 27 papers.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed
13.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04537650 completednot on this map

The Pathophysiology of Swallowing Impairment in People Recovering From COVID-19

TypeobservationalSponsorUniversity Health Network, TorontoRan2021 to 2022Enrolled44ConditionsCovid19ArmsVideofluoroscopic Swallowing Study (VFSS)
3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 30 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. What the "Voices" of Dysphagia Are Thinking about Its Future.International archives of otorhinolaryngology · 2026
    Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Risk factors for dysphagia after stroke and efficacy evaluation of swallowing function training.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Article
  17. Article
  18. Article
  19. Article
  20. Preliminary Exploration of Variations in Measures of Pharyngeal Area During Nonswallowing Tasks.Journal of speech, language, and hearing research : JSLHR · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 2 countries.

Catriona M SteeleKITE Research Institute, University Health Network, Toronto, Ontario, Canada.ORCID 0000-0002-4294-6561
Mark T BayleyKITE Research Institute, University Health Network, Toronto, Ontario, Canada.ORCID 0000-0001-7860-9463
Mary Kathryn BohnDepartment of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID 0000-0003-3464-5221
Victoria HigginsDynaLIFE Medical Labs, Edmonton, Alberta, Canada.ORCID 0000-0002-7463-9320
Melanie Peladeau-PigeonKITE Research Institute, University Health Network, Toronto, Ontario, Canada.
Vathany KulasingamDepartment of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada.ORCID 0000-0001-5610-873X
Google (United States) · US

Funding

Establishing Reference Values and Clinical Decision Points for Quantitative Videofluoroscopic Measures of SwallowingR01AG077481 · NIA · UNIVERSITY HEALTH NETWORK · PI Emily Kate Plowman, Catriona Margaret Steele · 2022 to 2026
$4.3M
Tongue-pressure timing for liquid flow detection and control in swallowingR01DC011020 · NIDCD · UNIVERSITY HEALTH NETWORK · PI STEELE, CATRIONA MARGARET · 2010 to 2020
$2.9M
NIA NIH HHS R01 AG077481NIDCD NIH HHS R01 DC011020
6 · The paper itself

Abstract

purposeIt is essential that clinicians have evidence-based benchmarks to support accurate diagnosis and clinical decision making. Recent studies report poor reliability for diagnostic judgments and identifying mechanisms of impairment from videofluoroscopy (VFSS). Establishing VFSS reference values for healthy swallowing would help resolve such discrepancies. Steele et al. (2019) released preliminary reference data for quantitative VFSS measures in healthy adults aged < 60 years. Here, we extend that work to provide reference percentiles for VFSS measures across a larger age span.

methodData for 16 VFSS parameters were collected from 78 healthy adults aged 21-82 years (39 male). Participants swallowed three comfortable sips each of thin, slightly, mildly, moderately, and extremely thick barium (20% w/v). VFSS recordings were analyzed in duplicate by trained raters, blind to participant and task, using the Analysis of Swallowing Physiology: Events, Kinematics and Timing (ASPEKT) Method. Reference percentiles (p2.5, 5, 25, 50, 75, 95, and 97.5) were determined as per Clinical and Laboratory Standards Institute EP28-A3c guidelines.

resultsWe present VFSS reference percentile tables, by consistency, for (a) timing parameters (swallow reaction time; the hyoid burst-to-upper esophageal sphincter (UES)-opening interval; UES opening duration; time-to-laryngeal vestibule closure (LVC); and LVC duration) and (b) anatomically scaled pixel-based measures of maximum UES diameter, pharyngeal area at maximum pharyngeal constriction and rest, residue (vallecular, pyriform, other pharyngeal locations, total), and hyoid kinematics (X, Y, XY coordinates of peak position; speed). Clinical decision limits are proposed to demarcate atypical values of potential clinical concern.

conclusionThese updated reference percentiles and proposed clinical decision limits are intended to support interpretation and reliability for VFSS assessment data. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24043041.

Indexed as

DeglutitionDeglutition DisordersAdultEsophageal Sphincter, UpperFluoroscopyHumansMaleReference ValuesReproducibility of Results

Identifiers

PMID37669617
PMCPMC10713020
OpenAlexW4386447025

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.