, Volume 23, Issue 4, pp 392–405 | Cite as

MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard

  • Bonnie Martin-HarrisEmail author
  • Martin B. Brodsky
  • Yvonne Michel
  • Donald O. Castell
  • Melanie Schleicher
  • John Sandidge
  • Rebekah Maxwell
  • Julie Blair
Original Article


The aim of this study was to test reliability, content, construct, and external validity of a new modified barium swallowing study (MBSS) tool (MBSImp) that is used to quantify swallowing impairment. Multiple regression, confirmatory factor, and correlation analyses were used to analyze 300 in- and outpatients with heterogeneous medical and surgical diagnoses who were sequentially referred for MBS exams at a university medical center and private tertiary care community hospital. Main outcome measures were the MBSImp and index scores of aspiration, health status, and quality of life. Inter- and intrarater concordance were 80% or greater for blinded scoring of MBSSs. Regression analysis revealed contributions of eight of nine swallow types to impressions of overall swallowing impairment (p ≤ 0.05). Factor analysis revealed 13 significant components (loadings ≥ 0.5) that formed two impairment groupings (oral and pharyngeal). Significant correlations were found between Oral and Pharyngeal Impairment scores and Penetration-Aspiration Scale scores, and indexes of intake status, nutrition, health status, and quality of life. The MBSImp demonstrated clinical practicality, favorable inter- and intrarater reliability following standardized training, content, and external validity. This study reflects potential for establishment of a new standard for quantification and comparison of oropharyngeal swallowing impairment across patient diagnoses as measured on MBSS.


Dysphagia Swallowing Videofluoroscopy Diagnostic tool Reliability Deglutition Deglutition disorders 



The authors thank all of the patients who graciously offered their time. This study was funded by the National Institute on Deafness and Other Communication Disorders at the National Institutes of Health (NIDCD K23 DC005764) and by the Mark and Evelyn Trammell Trust, Atlanta, Georgia. The authors extend their gratitude to the members of the multidisciplinary panel that convened to validate the measures for their time and collaborative efforts. They are (in alphabetical order) Donald Castell, MD; Bronwyn Jones, MD; Susan Langmore, PhD, Cathy Lazarus, PhD, Fred McConnel, MD, Jeffrey Palmer, MD, Adrienne Perlman,PhD, JoAnne Robbins, PhD, John Rosenbek, PhD, Reza Shaker, MD, and Barbara Sonies, PhD. The authors thank the speech-language pathologists who were trained for scoring and assisted with data collection and scored over 300 patients for their countless hours, dedication, and perseverance through this project. They are (in alphabetical order) Audra Condon, Grea Durkee, K. Val Evans, Margie Hunnel, Caroline Mitchell, Kristin Thayer, and Tanya Thomason.


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Bonnie Martin-Harris
    • 1
    • 2
    • 3
    • 4
    Email author
  • Martin B. Brodsky
    • 1
    • 2
    • 3
    • 5
    • 8
  • Yvonne Michel
    • 6
  • Donald O. Castell
    • 7
  • Melanie Schleicher
    • 4
  • John Sandidge
    • 4
  • Rebekah Maxwell
    • 2
    • 3
    • 5
  • Julie Blair
    • 2
    • 3
    • 5
  1. 1.Department of Otolaryngology-Head and Neck SurgeryMedical University of South CarolinaCharlestonUSA
  2. 2.Evelyn Trammell Institute for Voice and SwallowingMedical University of South CarolinaCharlestonUSA
  3. 3.Department of Communication Sciences & DisordersMedical University of South CarolinaCharlestonUSA
  4. 4.Evelyn Trammell Voice & Swallowing CenterSaint Joseph’s Hospital of AtlantaAtlantaUSA
  5. 5.Department of Speech PathologyMedical University of South CarolinaCharlestonUSA
  6. 6.College of NursingMedical University of South CarolinaCharlestonUSA
  7. 7.College of MedicineMedical University of South CarolinaCharlestonUSA
  8. 8.Johns Hopkins HospitalBaltimoreUSA

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