Purpose: The purpose of this study was to extend the assessment of the psychometric properties of the Modified Barium Swallow Impairment Profile (MBSImP). Here, we re-examined structural validity and internal consistency using a large clinical-registry data set and formally examined rater reliability in a smaller data set. Method: This study consists of a retrospective structural validity and internal consistency analysis of MBSImP using a large data set ( N = 52,726) drawn from the MBSImP Swallowing Data Registry and a prospective study of the interrater and intrarater reliability of a subset of studies ( N = 50) rated by four MBSImP-trained speech-language pathologists. Structural validity was assessed via exploratory factor analysis. Internal consistency was measured using Cronbach's alpha for each of the multicomponent MBSImP domains, namely, the oral and pharyngeal domains. Interrater reliability and intrarater reliability were measured using the intraclass correlation coefficient (ICC). Results: The exploratory factor analysis showed a two-factor solution with factors precisely corresponding to the scale's oral and pharyngeal domains, consistent with findings from the initial study. Component 17, that is, the esophageal domain, did not load onto either factor. Internal consistency was good for both the oral and pharyngeal domains (α oral = .81, α pharyngeal = .87). Interrater reliability was found to be good with ICC interrater = .78 (95% confidence interval [CI; .76, .80]). Intrarater reliability was good for each rater, ICC Rater-1 = .82 (95% CI [.77, .86]), ICC Rater-2 = .83 (95% CI [.79, .87]), ICC Rater-3 = .87 (95% CI [.83, .90]), and ICC Rater-4 = .87 (95% CI [.83, .90]). Conclusions: This study leverages a large-scale, clinical data set to provide strong, generalizable evidence that the MBSImP assessment method has excellent structural validity and internal consistency. In addition, the results show that MBSImP-trained speech-language pathologists can demonstrate good interrater and intrarater reliability.
ABSTRACT Background Dysphagia (difficulty swallowing) is a common morbidity resulting from the treatment of head‐and‐neck squamous‐cell carcinoma (HNSCC) due to surgery and chemoradiation. Transoral robotic surgery (TORS) is a minimally invasive surgical technique for the management of HNSCC, which ideally avoids many of the known complications of open surgery. Research describing physiologic swallowing impairment after surgery using videofluoroscopy is lacking. Methods We evaluated videofluoroscopic swallowing studies of 37 patients who received TORS for head and neck cancer using a validated scoring tool, the Modified Barium Swallow Impairment Profile (MBSImP), at three time points including baseline. Results Patients had worsened physiologic impairments in the immediate post‐operative and late post‐operative periods, particularly in components related to airway protection. Many patients also had baseline swallowing impairment. Conclusions Further research is required to elucidate dysphagia at discrete time points before and after treatment as well as with different and evolving adjuvant therapy protocols.
Purpose: The purpose of the present study was to use a large swallowing database to explore and compare the swallow-physiology impairment profiles of five dysphagia-associated diagnoses: chronic obstructive pulmonary disease (COPD), dementia, head and neck cancer (HNC), Parkinson's disease (PD), and stroke. Method: A total of 8,190 patients across five diagnoses were extracted from a de-identified swallowing database, that is, the Modified Barium Swallow Impairment Profile Swallowing Data Registry, for the present exploratory cross-sectional analysis. To identify the impairment profiles of the five diagnoses, we fit 18 partial proportional odds models, one for each of the 17 Modified Barium Swallow Impairment Profile components and the Penetration–Aspiration Scale, with impairment score as the dependent variable and diagnoses, age, sex, and race as the independent variables with interactions between age and diagnoses and between PD and dementia (in effect creating a PD with dementia [PDwDem] group). For components with > 5% missingness, we applied inverse probability weighting to correct for bias. Results: PD and COPD did not significantly differ on 13 of the 18 outcome variables (all p s > .02). Dementia, stroke, and PDwDem all showed worse impairments than COPD or PD on five of six oral components (all p s < .007). HNC had worse impairment than all diagnoses except PDwDem for nine of 10 pharyngeal components (all p s < .006). Stroke and HNC had worse penetration/aspiration than all other diagnoses (all p s < .003). Conclusions: The present results show that there are both common and differing impairment profiles among these five diagnoses. These commonalities and differences in profiles provide a basis for the generation of hypotheses about the nature and severity of dysphagia in these populations. These results are also likely highly generalizable given the size and representativeness of the data set. Supplemental Material: https://doi.org/10.23641/asha.27478245
