Where Do Clinicians Look When Viewing Videofluoroscopic Swallow Studies? A Pilot Eye-Tracking Study

Area of Science:

• Clinical Neuroscience
• Speech and Hearing Science

Background:

• Videofluoroscopic swallow studies (VFSS) are crucial for assessing swallowing disorders.
• Understanding the visual assessment process during VFSS review is essential for improving diagnostic accuracy.

Purpose of the Study:

• To investigate how speech-language pathologists (SLPs) visually assess VFSS using eye-tracking data.
• To identify challenges and barriers in applying eye-tracking methodology to VFSS review.

Main Methods:

• Thirteen SLPs reviewed two 5-ml thin liquid swallows while eye movements were recorded.
• Fixation counts were analyzed across anatomically relevant areas of interest (AOIs).
• Data were analyzed descriptively, with statistical comparisons using the Wilcoxon signed-ranks test.

Main Results:

• A decline in fixation count rate was observed in the second swallow.
• Significant variability in eye-gaze behavior was noted across participants.
• The bolus received the highest fixation count, with attention shifting from anterior-superior to posterior-inferior structures between swallows.
• Methodological challenges included defining dynamic AOIs and handling missing gaze data.

Conclusions:

• Eye tracking provides insights into SLPs' visual attention during VFSS review.
• Variable gaze patterns and methodological hurdles were identified.
• Further research is needed to link gaze behavior to VFSS interpretation and inform clinical training.