Skip to main content
SpringerLink
Log in

Simple Swallowing Provocation Test Has Limited Applicability as a Screening Tool for Detecting Aspiration, Silent Aspiration, or Penetration

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

A number of tests for evaluating dysphagia without using videofluoroscopic examination of swallowing (VF) or videoendoscopic evaluation of swallowing (VE) have been developed. The simple swallowing provocation test (SSPT) is unique because it is performed while in a supine position and does not require the patient’s cooperation. However, whether the SSPT detects aspiration or penetration correctly is unclear because its validity determined by VF or VE has not been evaluated. Therefore, we determined the sensitivity, specificity, and predictive accuracy of SSPT followed by VF in 45 patients. The sensitivities of the first-step and the second-step SSPT for the detection of aspiration, silent aspiration, or penetration were 72–75% and 13–17%, respectively; the specificities of the first-step and the second-step SSPT were 38–44% and 80–89%, respectively; and the predictive accuracies of the first-step and the second-step SSPT were 58–67% and 31–49%, respectively. These data suggest that SSPT has limited applicability as a screening tool for aspiration, silent aspiration, or penetration because of its low sensitivity. This test may be useful for patients who cannot undergo other tests due to cognitive and/or linguistic dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Colodny N. Interjudge and intrajudge reliabilities in fiberoptic endoscopic evaluation of swallowing (FEES®) using the penetration-aspiration scale: a replication study. Dysphagia. 2002;17:308–15. doi:10.1007/s00455-002-0073-4.

    Article  PubMed  Google Scholar 

  2. DePippo KL, Holas MA, Reding MJ. Validation of the 3-oz water swallow test for aspiration following stroke. Arch Neurol. 1992;49:1259–61.

    CAS  PubMed  Google Scholar 

  3. Tohara H, Saitoh E, Mays KA, Kuhlemeier K, Palmer JB. Three tests for predicting aspiration without videofluorography. Dysphagia. 2003;18:126–34. doi:10.1007/s00455-002-0095-y.

    Article  PubMed  Google Scholar 

  4. Teramoto S, Fukuchi Y. Detection of aspiration and swallowing disorder in older stroke patients: simple swallowing provocation test versus water swallowing test. Arch Phys Med Rehabil. 2000;81:1517–9. doi:10.1053/apmr.2000.9171.

    Article  CAS  PubMed  Google Scholar 

  5. Nishiwaki K, Tsuji T, Liu M, Hase K, Tanaka N, Fujiwara T. Identification of a simple screening tool for dysphagia in patients with stroke using factor analysis of multiple dysphagia variables. J Rehabil Med. 2005;37:247–51. doi:10.1080/16501970510026999.

    Article  PubMed  Google Scholar 

  6. Lim SHB, Lieu PK, Phua SY, Seshadri R, Venketasubramanian N, Lee SH, et al. Accuracy of bedside clinical methods compared with fiberoptic endoscopic examination of swallowing (FEES) in determining the risk of aspiration in acute stroke patients. Dysphagia. 2001;16:1–6. doi:10.1007/s004550000038.

    Article  CAS  PubMed  Google Scholar 

  7. Oguchi K, Saitoh E, Baba M, Kusudo S, Tanaka T, Onogi K. The repetitive saliva swallowing test (RSST) as a screening test of functional dysphagia (2). Validity of RSST. Jpn J Rehabil Med. 2000;37:383–8.

    Google Scholar 

  8. Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A, et al. Dysphagia bedside screening for acute-stroke patients. The Gugging Swallowing Screen. Stroke. 2007;38:2948–52. doi:10.1161/STROKEAHA.107.483933.

    Article  PubMed  Google Scholar 

  9. Teramoto S, Matsuse T, Fukuchi Y, Ouchi Y. Simple two-step swallowing provocation test for elderly patients with aspiration pneumonia. Lancet. 1999;353:1243. doi:10.1016/S0140-6736(98)05844-9.

    Article  CAS  PubMed  Google Scholar 

  10. Teramoto S, Matsuse T, Matsui H, Ohga E, Saitoh E, Ishii T, et al. The simple swallowing provocation test as a means of screening for swallowing disorders: a comparison with the water swallowing test. J Jpn Res Soc. 1999;37:466–70.

    CAS  Google Scholar 

  11. Teramoto S, Yamamoto H, Yamaguchi Y, Ouchi Y, Matsuse T. A novel diagnostic test for the risk of aspiration pneumonia in the elderly. Chest. 2004;125:801–2. doi:10.1378/chest.125.2.801.

    Article  PubMed  Google Scholar 

  12. Scott A, Perry A. Two-step swallowing provocation test for elderly patients. Lancet. 1999;353:2246. doi:10.1016/S0140-6736(05)76298-X.

    Article  CAS  PubMed  Google Scholar 

  13. Pouderoux P, Logemann JA, Kahrilas PJ. Pharyngeal swallowing elicited by fluid infusion: role of volition and vallecular containment. Am J Physiol. 1996;270:G347–54.

    CAS  PubMed  Google Scholar 

  14. Teramoto S, Matsuse T, Ouchi Y. Two-step swallowing provocation test for elderly patients. Authors’ reply. Lancet. 1999;353:2246. doi:10.1016/S0140-6736(05)76299-1.

    Article  Google Scholar 

  15. Teramoto S, Matsuse T, Fukuchi Y. Decision-making for safe feeding after stroke. Lancet. 2000;356:1352. doi:10.1016/S0140-6736(05)74258-6.

    Article  CAS  PubMed  Google Scholar 

  16. Langmore SE, Terpenning MS, Schork A, Chen Y, Murray JT, Lopatin D, et al. Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia. 1998;13:69–81. doi:10.1007/PL00009559.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan

    Hitoshi Kagaya, Eiichi Saitoh & Michio Yokoyama

  2. Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan

    Sumiko Okada & Mikoto Baba

  3. Department of Rehabilitation, Akita City Hospital, 4-30 Kawamoto Matsuoka-cho, Akita, 010-0933, Japan

    Hitomi Takahashi

Authors
  1. Hitoshi Kagaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sumiko Okada
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eiichi Saitoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mikoto Baba
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michio Yokoyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hitomi Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hitoshi Kagaya.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kagaya, H., Okada, S., Saitoh, E. et al. Simple Swallowing Provocation Test Has Limited Applicability as a Screening Tool for Detecting Aspiration, Silent Aspiration, or Penetration. Dysphagia 25, 6–10 (2010). https://doi.org/10.1007/s00455-009-9222-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-009-9222-3

Keywords

Search

Navigation