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Anterior-Posterior View Acquisition During Videofluoroscopy: A Survey Study Exploring Influential Factors on
R Brynn Jones-Rastelli1, Xi Tang2, Daphna Harel2
1Department of Communicative Sciences and Disorders, NYU School of Culture Education and Human Development, New York University, NY.
Journal of Speech, Language, and Hearing Research : JSLHR
|October 30, 2024
Summary
Speech-language pathologists (SLPs) routinely include the anterior-posterior (AP) view in videofluoroscopic swallowing studies (VFSSs) when supported by evidence-based practice, departmental culture, and radiologist endorsement. Environmental and organizational factors significantly influence this clinical decision-making process.
Area of Science:
- Clinical Practice
- Diagnostic Imaging
- Swallowing Disorders
Background:
- Videofluoroscopic swallowing studies (VFSSs) are crucial for assessing dysphagia.
- The anterior-posterior (AP) view in VFSSs provides unique diagnostic information.
- Factors influencing the routine inclusion of the AP view in clinical practice remain underexplored.
Purpose of the Study:
- To investigate the determinants influencing speech-language pathologists' (SLPs') decisions regarding the inclusion of the anterior-posterior (AP) view during VFSSs in the United States.
- To identify facilitators and barriers associated with AP view utilization in clinical swallowing assessments.
Main Methods:
- An anonymous online survey was administered to SLPs who perform VFSSs.
- The survey assessed clinician demographics, practice patterns, diagnostic perceptions, professional influences, training, and logistical factors.
- Binary logistic regression analysis was employed to determine the relationship between survey constructs and the likelihood of AP view inclusion.
Main Results:
- 64% of surveyed SLPs routinely obtained an AP view during VFSSs.
- Facilitators included post-acute settings, alignment with evidence-based practice, perceived diagnostic value, departmental support, minimal equipment limitations, and radiologist support.
- Barriers identified were Southern U.S. geographic location, influence of coworker opinions, and productivity tracking.
Conclusions:
- Environmental and organizational factors play a substantial role in shaping AP view inclusion practices during VFSSs.
- Clinical decision-making regarding AP view utilization is influenced by a complex interplay of individual perceptions, professional norms, and systemic support.
