Main Logo
Logo

Society for Pediatric Radiology – Poster Archive

  125
  0
  0
 
 


Final ID: Poster #: EDU-026

Novel Guidelines for Videofluoroscopic Swallowing Studies Referral and Follow-Up

Purpose or Case Report: Videofluoroscopic swallowing studies (VFSS) are used to assess dysphagia in the pediatric population in conjunction with the Penetration-Aspiration Scale (PAS), which describes the degree of airway invasion during swallowing. However, guidelines regarding indications and follow-up are varied and vague, and often lead to over-referral, over and undertreatment, and follow-up that does not always benefit patients (i.e inadequate interventions in the interim to yield improvement). The aim of our work is to present clear guidelines for VFSS indications and follow-up to reduce unnecessary referrals, and promote clinically significant follow-up management.
Methods & Materials: Over the last eight years at our tertiary pediatric care centre, a multidisciplinary team has led a quality improvement program, involving observations of clinical practice and literature review, to identify shortcomings of the current indications and follow-up management surrounding VFSS.
Results: We developed a 10-point list of indications with specific clinical signs and conditions that warrant VFSS referral. This advances on guidelines proposed in the literature by including signs that are easily observed by parents and, in turn, better elucidated on history by physicians. These specific indications aim to decrease unwarranted referrals. We also propose a screening form handled by occupational therapists to preliminarily assess patients to ensure clinical benefit.

Furthermore, we discuss the importance of recording data complementary to the PAS such as positioning, vessel, and food textures. Although the PAS theoretically allows for objective scores to assess interval change, the literature suggests that these aforementioned factors influence penetration-aspiration, and thus we recommend consistency among these factors, when possible.

We propose a follow-up centered around functionality change as opposed to a time-based follow-up. Markers such as intake vessel changes (i.e child graduates from bottle to cup use) or clinical improvement or deterioration should be reasons for VFSS repeat. Compared to rigid time-based follow up, this increases efficiency by ensuring those in need of follow-up for functional changes can receive it, and minimises unnecessary follow-up and irradiation.
Conclusions: Our reformed guidelines aim to reduce unnecessary VFSS referral and optimize follow-up for patients to promote clinically significant impacts. These guidelines can improve VFSS referral and follow-up in the primary care setting.
  • Damer, Alameen  ( University of Ottawa Faculty of Medicine , Ottawa , Ontario , Canada )
  • Damer, Reham  ( University of Ottawa Faculty of Medicine , Ottawa , Ontario , Canada )
  • Davila, Jorge  ( Children's Hospital of Eastern Ontario , Ottawa , Ontario , Canada )
Session Info:

Posters - Educational

GI

SPR Posters - Educational

More abstracts on this topic:
It hurts when I swallow!

Guirguis Albair, Lampl Brooke, Park Ellen, Mamoun Ihsan

Hyperechoic Renal Parenchyma in Neonates and Young Infants – Normal-Appearance, Pathology, and Pitfalls. A Case-Based Review

Ahn Ju Hee, Hook Marcus, Swenson Zachary, King Cody

More abstracts from these authors:
Differences of Placental ADC Measurements in Fetuses with and without CNS Abnormalities

Valdez Quintana Melissa, Caro Dominguez Pablo, Grynspan David, Hurteau-miller Julie, Davila Jorge, Moretti Felipe, Miller Elka

Diagnostic accuracy of MR Enterography detecting mucosal healing in Pediatric Crohn’s disease.

Davila Jorge, Highmore Kerri, Miller Elka

Preview
Poster____EDU-026.pdf
You have to be authorized to contact abstract author. Please, Login or Signup.

Please note that this is a separate login, not connected with your credentials used for the SPR main website.

Not Available

Comments

We encourage you to join the discussion by posting your comments and questions below.

Presenters will be notified of your post so that they can respond as appropriate.

This discussion platform is provided to foster engagement, and stimulate conversation and knowledge sharing.

Please click here to review the full terms and conditions for engaging in the discussion, including refraining from product promotion and non-constructive feedback.

 

You have to be authorized to post a comment. Please, Login or Signup.

Please note that this is a separate login, not connected with your credentials used for the SPR main website.


   Rate this abstract  (Maximum characters: 500)