Noninvasive detection of thin-liquid aspiration using dual-axis swallowing accelerometry
July 1, 2012
Aspiration (the entry of foreign contents into the upper airway) is a serious concern for individuals with dysphagia and can lead to pneumonia. However, overt signs of aspiration, such as cough, are not always present, making non-instrumental diagnosis challenging. Valid, reliable tools for detecting aspiration during clinical screening and assessment are needed. In this study, we investigated the validity of a noninvasive accelerometry signal processing classifier for detecting aspiration. Dual-axis cervical accelerometry signals were collected from 40 adults on thin-liquid swallowing tasks during videofluoroscopic swallowing examinations. Signal processing algorithms were used to remove known sources of artifact and a classifier was trained to identify signals associated with penetration-aspiration. Validity was measured in comparison to blinded ratings of penetration-aspiration from the concurrently recorded videofluoroscopies. On a bolus-by-bolus basis, the accelerometry classifier had a 10% false negative rate (90% sensitivity) and a 23% false positive rate (77% specificity) for detecting penetrationaspiration. We conclude that accelerometry can be used to support valid, reliable and efficient detection of aspiration risk in patients with suspected dysphagia.
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