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Updated: Feb 25, 2026
Adapting Human Videofluoroscopic Swallow Study Methods to Detect and Characterize Dysphagia in Murine Disease Models
Published on: March 1, 2015
Development of a Dysphagia Screening Test for Preterm Infants (DST-PI)
Kyoung Moo Lee1, Young Tak Seo1
1Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
Insights
The Dysphagia Screening Test for Preterm Infants (DST-PI) effectively predicts swallowing difficulties in preterm infants. This simple test aids in early diagnosis and prevents respiratory issues.
Area of Science:
- Neonatology
- Pediatric Gastroenterology
- Speech-Language Pathology
Background:
- Dysphagia is a significant concern in preterm infants, impacting development and increasing respiratory complication risks.
- Early detection and intervention are crucial for managing dysphagia and its consequences in this vulnerable population.
Purpose of the Study:
- To develop and validate a simple, easy-to-apply screening tool, the Dysphagia Screening Test for Preterm Infants (DST-PI).
- To predict supraglottic penetration and subglottic aspiration in preterm infants, thereby aiding in early diagnosis and prevention of respiratory complications.
Main Methods:
- A videofluoroscopic swallowing study (VFSS) was conducted on 52 preterm infants with suspected dysphagia.
- A 7-item Dysphagia Screening Test for Preterm Infants (DST-PI) was developed using logistic regression, with sensitivity, specificity, and AUC calculated via ROC curve analysis.
- Inter-rater reliability was assessed using the kappa coefficient.
Main Results:
- The DST-PI includes 7 key items: gestational age, history of apnea, cyanosis during feeding, swallowing pattern, coughs, decreased oxygen saturation post-feeding, and voice change.
- The DST-PI demonstrated high correlation with the Penetration-Aspiration Scale (Spearman's rho = 0.807, p<0.001).
- High sensitivity (96.6%) and specificity (76.9%) were observed for detecting dysphagia at a cutoff value of 3.25.
Conclusions:
- The Dysphagia Screening Test for Preterm Infants (DST-PI) is a valid and reliable tool for screening dysphagia in preterm infants.
- Its ease of application makes it suitable for clinical settings, facilitating early identification of swallowing impairments.
- The DST-PI aids in predicting supraglottic penetration and subglottic aspiration, contributing to the prevention of respiratory complications.
Objective:
To explore both the early prediction and diagnosis of dysphagia in preterm infants as an important developmental aspect as well as the prevention of respiratory complications, we developed the simple and-easy-to-apply Dysphagia Screening Test for Preterm Infants (DST-PI) to predict supraglottic penetration and subglottic aspiration.
Methods:
Fifty-two infants were enrolled in a videofluoroscopic swallowing study (VFSS) due to clinical suspicions of dysphagia. Thirteen items related to supraglottic penetration or subglottic aspiration were initially selected from previous studies for the DST-PI. Finally, 7 items were determined by linear logistic regression analysis. Cutoff values, sensitivity, specificity, and the area under the ROC curve (AUC) of the DST-PI for predicting supraglottic penetration or subglottic aspiration were calculated using a ROC curve. For inter-rater reliability, the kappa coefficient was calculated.
Results:
Seven items were selected: 'gestational age,' 'history of apnea,' 'history of cyanosis during feeding,' 'swallowing pattern,' 'coughs during or after feeding,' 'decreased oxygen saturation within 3 minutes of feeding,' and 'voice change after feeding.' The Spearman correlation coefficient between the DST-PI and the penetration-aspiration scale (PAS) was 0.807 (p<0.001). The sensitivity and specificity at different cutoff values for detecting supraglottic penetration and subglottic aspiration were 96.6% and 76.9% at 3.25, and 88.9% and 75.8% at 6.25, respectively.
Conclusion:
The DST-PI is a valid and reliable dysphagia screening test for supraglottic penetration or subglottic aspiration in preterm infants that is easy to apply in a clinical context.
