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Updated: Nov 1, 2025
Coordinate Mapping of Hyolaryngeal Mechanics in Swallowing
Published on: May 6, 2014
Evaluation of the Modified Barium Swallow Study Conducted With and Without Radiologist Supervision: A Pre- and
Luhe Yang1, David Leswick1, Michael Butler2
1Department of Medical Imaging, Saskatchewan Health Authority and University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Purpose:
Assess quality metrics of modified barium swallow studies (MBSS) with and without a radiologist present during the procedure.
Methods:
Retrospective review of MBSS performed on adult inpatients at a tertiary care hospital 6-months pre- and post-institutional change from having to not having a radiologist present during the examination.
Factors Assessed Included:
fluoroscopy time; study duration; number of cine loops; number of images; efficiency of collimation (using a 5-point scoring system); time to final report; radiologist-speech language pathologist report disagreement; and recalls for inadequate studies. Statistical analysis was via Welch's t-test and a test of proportions for continuous and count data under the normal approximation.
Results:
106 and 119 MBSS were analyzed from the radiologist present and radiologist absent periods, respectively. No statistically significant differences were found for: average fluoroscopy time (116.1 s vs. 126.9 s; P = 0.161); study duration (400.4 s vs. 417.3 s; P = 0.453); number of cine loops (9.3 vs. 10.2; P = 0.075); number of images (620.5 vs. 581.1; P = 0.350); or report disagreement. There was improved performance without the radiologist present for collimation (1.92 vs. 1.43; P = 0.003) and fewer non-diagnostic images (6.5 vs. 4.5; P = 0.001). Time to final report was longer with the radiologist absent due to more reports with significant delays. There were no repeated studies because of inadequate technique in either group.
Conclusion:
MBSS performed by technologists without radiologist supervision is not inferior to those performed with radiologist supervision on multiple performance measures. This supports technologist operated MBSS without radiologist supervision, while acknowledging a need to further address radiologist report time delay.
Insights
Modified barium swallow studies (MBSS) performed without a radiologist present showed no inferiority in quality metrics. This supports technologist-operated MBSS, though reporting time delays require further attention.
Area of Science:
- Radiology
- Medical Imaging
- Swallowing Disorders
Background:
- Modified barium swallow studies (MBSS) are crucial for evaluating dysphagia.
- Traditionally, radiologists supervise MBSS procedures.
- Evaluating the impact of radiologist presence on MBSS quality is important for optimizing healthcare resources.
Purpose of the Study:
- To compare quality metrics of MBSS performed with and without a radiologist present.
- To determine if technologist-operated MBSS without radiologist supervision is non-inferior to supervised MBSS.
Main Methods:
- A retrospective review of MBSS conducted on adult inpatients was performed.
- Data from periods with and without radiologist presence during MBSS were compared.
- Quality metrics included fluoroscopy time, study duration, image counts, collimation efficiency, and report turnaround time.
Main Results:
- No significant differences were observed in fluoroscopy time, study duration, cine loops, or image counts.
- Improved collimation efficiency and fewer non-diagnostic images were noted when radiologists were absent.
- While no studies were recalled for inadequacy, report finalization time was longer without radiologist presence.
Conclusions:
- Modified barium swallow studies performed by technologists without direct radiologist supervision are not inferior in quality.
- These findings support the efficacy of technologist-operated MBSS.
- Further investigation is needed to address delays in final report generation when radiologists are not present.
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