Videofluoroscopic assessment of dysphagia: A questionnaire survey of protocols, roles and responsibilities of radiology and speech and language therapy personnel

Abstract 

Videofluoroscopy (VF) is the ‘gold standard’ assessment for oropharyngeal dysphagia and radiographers are beginning to direct this examination independently, yet little is known about the roles and responsibilities of the core professions of radiology and speech and language therapy and their practice in this examination.

Aim

To evaluate VF practice and identify the roles and responsibilities of radiology and speech and language therapy personnel.

Materials and methods

A questionnaire was developed and distributed to speech and language therapists (SALT) and radiologists via national special interest networks. Information regarding protocols, test materials, supervision, radiation protection and training was obtained.

Results

One hundred and thirteen questionnaires were completed, 83% of respondents had more than 5 years service. Most were carrying out VF on an ‘ad hoc’ basis with only 32% participating in more than 6 assessments per month. There was no consensus on protocol and 41% chose to thicken barium solutions by adding more barium sulphate powder, potentially predisposing patients to complications. Over 50% of SALTs had received one day post-graduate training in VF, whereas, only one radiologist had specific VF training.

Conclusion

Despite its importance in determining the feeding route for patients, VF is carried out infrequently by most clinicians and protocols vary widely. Moreover, intra- and inter-disciplinary training and supervision is minimal. More work is needed to develop standard guidelines, to improve the quality of the examination and its reproducibility.

Keywords: Barium, Deglutition, Radiation protection, Protocols, Swallowing, Competency