Does Reducing Videofluoroscopy Frame Rate Affect DIGEST Grades in Modified Barium Swallow Studies?

Area of Science:

• Medical Imaging
• Speech-Language Pathology
• Gastroenterology

Background:

• Modified Barium Swallow (MBS) studies are crucial for assessing swallowing disorders.
• Reduced frame rates in MBS may impact the reliability of swallowing safety and efficiency ratings.
• The impact of frame rate reduction on the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) system is not well understood.

Purpose of the Study:

• To evaluate the reliability of the DIGEST grading system under reduced frame rates (30, 15, and 7.5 FPS).
• To determine if frame rate variations affect the assessment of swallowing safety and efficiency using the DIGEST system.

Main Methods:

• Analysis of 315 Modified Barium Swallow (MBS) videos from 278 patients, predominantly those with head and neck cancer.
• Pairwise comparison of DIGEST grades and its components (Safety, Efficiency) at different simulated frame rates (30, 15, 7.5 FPS).
• Statistical analysis using Weighted Cohen's kappa and exact agreement metrics.

Main Results:

• Weighted Cohen's kappa values consistently exceeded 0.84, indicating "almost perfect" agreement across all frame rate comparisons.
• Exact agreement for all DIGEST grade comparisons surpassed 85%.
• The DIGEST system demonstrated high reliability irrespective of the tested frame rates.

Conclusions:

• The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) system is robust to variations in frame rate.
• Reduced frame rates do not compromise the reliability of DIGEST assessments for swallowing safety and efficiency.
• Findings support the potential use of lower frame rates in clinical MBS studies without sacrificing diagnostic accuracy.