Standardization of Videofluoroscopic Swallow Studies for Bottle-Fed Children

描述（由申请人提供）：吞咽障碍（吞咽困难）和相关风险在幼儿中增加。电视透视吞咽研究（VFSS），用于评估吞咽困难的主要方法，越来越多地在奶瓶喂养的儿童中进行。然而，没有标准化的方法来表征吞咽障碍的类型和严重程度。这个项目的目标是开发和测试一个标准化的测量工具和评分模式，用于量化奶瓶喂养儿童的吞咽障碍。在目标1中，我们将根据评估者可靠性和因子分析的测量结果，从两个临床研究中心训练有素的言语语言病理学家（SLP）对300次VFSS考试的评分中，经验性地将工具的组成部分减少到一个可靠、简约和临床相关的集合中。我们假设SLP内和SLP之间至少有80%的可靠性，最终的一组组件将分布到五个功能域。在目标2中，我们将通过描述工具上的组成部分得分与健康，发展和幸福的外部指标之间的关系来确定每个领域内组成部分的结构效度。我们假设工具得分越高（吞咽功能越差），健康、发育和幸福指数越差。在目标3中，我们将测量在VFSS期间引入不同液体时生理性吞咽障碍评分的变化。我们假设损伤评分在两组之间会有所不同。这些研究将有助于开发一种临床实用、可靠和有效的标准化工具，用于评估、测量和报告奶瓶喂养儿童的生理性吞咽障碍，最终改善对患有这种疾病的儿童的诊断和管理。公共卫生和安全相关性：吞咽功能障碍在幼儿中越来越常见，并伴有严重后果。这项研究将有助于改善受影响儿童的诊断，护理和结局：（1）为表征和跟踪吞咽障碍的自然史提供基础，（2）为吞咽困难的干预措施提供结局指标，（3）作为诊断为与吞咽困难相关的特定诊断条件的儿童临床试验的生物标志物。这一标准化、可靠和经过验证的工具将通过网上培训模块立即传播。

DESCRIPTION (provided by applicant): Swallowing disorders (dysphagia) and associated risks have increased in young children. Videofluoroscopic swallowing studies (VFSS), the primary method used to evaluate dysphagia, are increasingly performed in bottle-fed children. However, there are no standardized approaches to characterize the type and severity of the swallowing impairment. The goal of this project is to develop and test a standardized measurement tool and scoring schema for the quantification of swallowing impairment in bottle-fed children. In Aim 1, we will empirically reduce components for the tool into a reliable, parsimonious, and clinically relevant set based on measures of rater reliability and factor analysis from the scoring of 300 VFSS exams by trained speech-language pathologists (SLPs) at two clinical sites. We hypothesize at least 80% reliability within and between SLPs and the final set of components will be distributed into five functional domains. In Aim 2, we will establish the construct validity of the components within each domain by characterizing the relationship between component scores on the tool and external indicators of health, development, and well-being. We hypothesize that higher scores on the tool (poorer swallowing function), will be associated with poorer indicators of health, development, and well-being. In Aim 3, we will measure changes in physiologic swallowing impairment scores when different liquid consistencies are introduced during the VFSS. We hypothesize impairment scores will differ between consistencies. These studies will help develop a clinically practical, reliable, and valid standardized tool for assessing, measuring, and reporting physiologic swallowing impairment in bottle-fed children, ultimately resulting in improved diagnosis and management of children with this condition. PUBLIC HEALTH AND SAFETY RELEVANCE: Swallowing dysfunction is increasingly common in young children and associated with significant consequences. This study will help to improve the diagnosis, care, and outcomes of affected children by: (1) providing a basis for characterizing and tracking the natural history of swallowing impairments, (2) providing outcome measures for interventions for dysphagia, and (3) serving as biomarkers for clinical trials with children diagnosed with specific diagnostic conditions associated with dysphagia. The standardized, reliable, and validated tool will be available for immediate dissemination through web-based training modules.