MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard

• Published in: Dysphagia 2008-12, Vol.23 (4), p.392-405
• Main Authors: Martin-Harris, Bonnie, Brodsky, Martin B., Michel, Yvonne, Castell, Donald O., Schleicher, Melanie, Sandidge, John, Maxwell, Rebekah, Blair, Julie
• Format: Article
• Language: English
• Subjects: Data Interpretation, Statistical; Deglutition; Deglutition Disorders - diagnosis; Deglutition Disorders - physiopathology; Gastroenterology; Hepatology; Humans; Imaging; Medicine; Medicine & Public Health; Original Article; Otorhinolaryngology; Photofluorography - instrumentation; Radiology; Regression Analysis; Reproducibility of Results; Statistics as Topic; United States
• ISSN: 0179-051X; 1432-0460
• DOI: 10.1007/s00455-008-9185-9

The aim of this study was to test reliability, content, construct, and external validity of a new modified barium swallowing study (MBSS) tool (MBSImp) that is used to quantify swallowing impairment. Multiple regression, confirmatory factor, and correlation analyses were used to analyze 300 in- and outpatients with heterogeneous medical and surgical diagnoses who were sequentially referred for MBS exams at a university medical center and private tertiary care community hospital. Main outcome measures were the MBSImp and index scores of aspiration, health status, and quality of life. Inter- and intrarater concordance were 80% or greater for blinded scoring of MBSSs. Regression analysis revealed contributions of eight of nine swallow types to impressions of overall swallowing impairment ( p  ≤ 0.05). Factor analysis revealed 13 significant components (loadings ≥ 0.5) that formed two impairment groupings (oral and pharyngeal). Significant correlations were found between Oral and Pharyngeal Impairment scores and Penetration-Aspiration Scale scores, and indexes of intake status, nutrition, health status, and quality of life. The MBSImp demonstrated clinical practicality, favorable inter- and intrarater reliability following standardized training, content, and external validity. This study reflects potential for establishment of a new standard for quantification and comparison of oropharyngeal swallowing impairment across patient diagnoses as measured on MBSS.