Clinical Utility of the Modified Barium Swallow
Abstract
The purpose of this investigation was to evaluate the immediate and clinically relevant information gained from the modified barium swallow study and to determine the impact of the procedure on patient management. A database containing a nonrandom sample of 608 swallowing studies was reviewed. Results showed that only 10.4% of the studies were classified as normal examinations and aspiration occurred in 32.4%. However, swallowing abnormality without aspiration was recorded in 57.2% of the studies. Five additional outcome variables were assessed: referrals made to other specialties, effectiveness of applied compensatory strategies, treatment recommendations, mode of intake change, and diet grade change. Nearly 83% of the 608 studies showed change in at least one of the variables: needed referral to a specialist was identified on 26.3%; compensatory strategies that improved swallow physiology were identified on 48.4%; swallowing therapy was recommended on 37.2%; changes in mode of intake occurred on 31.4%; and diet texture changes were recommended on 43.8%. The low percentage of normal studies coupled with the high percentage of change in measurable variables indicate high clinical utility for the modified barium swallow study. The misguided tendency to refer to the modified barium study only as a tool for identifying aspiration and the appropriate utilization of the examination for identification of underlying abnormality in swallowing physiology are explained.
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Previous research has linked greater thickness and higher textures to greater intake restriction.
“This rank ordering was based on previous research that related greater thickness and higher textures to greater intake restriction [37].”
From MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard (2008) · cites this paper as [37]
The smallest liquid volumes used for administration and scoring were regarded as typical practice, safe, and manageable even for severely dysphagic patients under controlled radiology observation.
“The smallest liquid volumes selected for administration and scoring in this investigation are considered representative of standard practice, safe and manageable by even the most severely dysphagic patients who are carefully observed in the controlled radiology environment during the MBS [37].”
From MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard (2008) · cites this paper as [37]
The MBSS permits detection of the presence and timing of aspiration and helps identify its physiologic and often treatable causes.
“The MBSS also permits detection of the presence and timing of aspiration, i.e., entry of ingested material below the level of the true vocal folds into the trachea, and assists in identifying the physiologic and often treatable cause(s) of the aspiration [35–38].”
From MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard (2008) · cites this paper as [37]
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- Authors
- Martin-Harris, B., Logemann, J. A., McMahon, S., Schleicher, M., & Sandidge, J.
- Affiliations
- Northwestern University (US)
- Emory University (US)
- University of Georgia (US)
- Venue
- Dysphagia
- Published
- 2000-06
- Volume
- 15
- Issue
- 3
- Pages
- 136-141
- ISSN
- 0179-051X (ISSN-L)
- 1432-0460
- OpenAlex
- W1979045426
- Cited by
- 178
- References
- 16
- Citations by year
- 2026: 9 · 2025: 5 · 2024: 6 · 2023: 7 · 2022: 5 · 2021: 14 · 2020: 11 · 2019: 12 · 2018: 7 · 2017: 9 · 2016: 3 · 2015: 4 · 2014: 2 · 2013: 3 · 2012: 9
- FWCI
- 14.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Dysphagia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Physiology › Voice and Speech Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- modified barium swallow, clinical utility, aspiration, compensatory strategies, swallowing therapy, specialist referral, clinical management
- MeSH terms
- Aged, Barium Radioisotopes, Deglutition Disorders, Female, Humans, Male, Surveys and Questionnaires
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