Gravity Flow Test Comparisons for Mildly Thick Consistency

Simple measurement tools that provide objective information about the consistency of thickened liquids have received increasing attention given possible application to clinical practice for dysphagia. The International Dysphagia Diet Standardization Initiative (IDDSI) advocates the use of the IDDSI Flow Test for measuring thickness and verifying a prescribed level of consistency. This study compares gravity flow test measurements taken with two 10-ml syringes of starch and gum-thickened samples prepared to a mildly thick consistency using product label information. One of the 10-ml syringes met IDDSI specification and the other 10-ml syringe did not. Thickened samples also were measured using the line spread apparatus. The results showed that two syringes yielded significantly different gravity flow test measurements, often resulting in changes to the classification level of thickness. There was no effect of thickening agent. Line spread measurements did not vary from one another. Study findings indicate the importance of continued testing with the IDDSI Flow Test and education/awareness about the use of the IDDSI reference syringe. An essential aspect about the use of thickened liquids in dysphagia management is that beverage preparations represent their prescribed level of modification. The findings of this study indicate the importance of following syringe specifications when conducting gravity flow testing using the IDDSI methodology. The implication is that the wrong 10-ml syringe could result in errant clinical decisions in determining the accuracy of texture modifications, resulting in care providers who are more likely to over or under thicken modifications to achieve a targeted level of thickness.