ArticleJournal of human nutrition and dietetics : the official journal of the British Dietetic Association2026
Accuracy of Visual Inspection of Thickened Liquids: Implications for Multidisciplinary Dysphagia Management and Clinical Nutrition.
Article in Journal of human nutrition and dietetics : the official journal of the British Dietetic Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionTo evaluate the accuracy of visually estimating thickened liquid volume via video-observed conditions and to determine whether clinical experience or thickener composition influences judgement reliability.
methodsA cross-sectional online survey was administered to 57 practising speech-language pathologists (SLPs) and 50 postgraduate SLP students. Participants viewed four 12-s videos of fluids prepared to explicit International Dysphagia Diet Standardisation Initiative consistencies (Levels 1, 2 and 4) using starch and xanthan gum thickeners. Participants estimated the volumetric amount of thickener (in product-specific scoops) added to each sample.
resultsOverall accuracy was low, with no significant difference between students (49.5%) and practitioners (47.4%) (p = 0.60). Combined cohort analysis showed that years of clinical practice alone were not associated with improved fluid estimation accuracy (p = 0.38). Students significantly outperformed practitioners in identifying Level 4 starch-based liquids (88.0% vs. 68.4%, p = 0.028) but were inaccurate in identifying Level 4 xanthan gum-based liquids (2.0% vs. 29.8%, p < 0.001).
conclusionVisual fluid estimation via video is highly variable, and clinical experience alone was not associated with improved accuracy in this cohort. To optimise patient safety and prevent secondary complications like dehydration from over-thickening, multidisciplinary teams should supplement subjective clinical judgement with objective ways to ensure patients are receiving the appropriate level of thickened liquids.
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