Sensitivity and specificity of clinical/bedside examination signs for detecting aspiration in adults subsequent to stroke

While detecting the presence of aspiration is only one aspect of a noninstrumented examination of swallowing function, it is an important component due to its potential health status consequences. The purpose of this investigation was to investigate the sensitivity and specificity of clinical/bedside examination signs for predicting aspiration on videofluoroscopic examination of swallowing. Sixty consecutive, acute stroke patients were investigated with clinical/bedside and videofluoroscopic exams. Clinical signs consisted of history, oral motor/speech praxis, voice, and trial swallow ratings. Results confirm that more work needs to be done if data collected from noninstrumented examinations are to be strongly predictive of aspiration on VFSE. However, comparisons of the current results with previous investigations provides a promising framework for future research. Educational objectives: (1) To understand the use of sensitivity and specificity in detecting disease; (2) To understand the current evidence regarding clinical signs of aspiration. (C) 2001 Elsevier Science Inc. All rights reserved.