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Dysphagia
Published in: Dysphagia 5/2017

Open Access 01-10-2017 | Review Article

Reflections on Clinical and Statistical Use of the Penetration-Aspiration Scale

Authors: Catriona M. Steele, Karen Grace-Martin

Published in: Dysphagia | Issue 5/2017

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Abstract

The 8-point Penetration-Aspiration Scale (PAS) was introduced to the field of dysphagia in 1996 and has become the standard method used by both clinicians and researchers to describe and measure the severity of airway invasion during swallowing. In this article, we review the properties of the scale and explore what has been learned over 20 years of use regarding the construct validity, ordinality, intervality, score distribution, and sensitivity of the PAS to change. We propose that a categorical revision of the PAS into four levels of increasing physiological severity would be appropriate. The article concludes with a discussion of common errors made in the statistical analysis of the PAS, proposing that frequency distributions and ordinal logistic regression approaches are most appropriate given the properties of the scale. A hypothetical dataset is included to illustrate both the problems and strengths of different statistical approaches.
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Metadata
Title
Reflections on Clinical and Statistical Use of the Penetration-Aspiration Scale
Authors
Catriona M. Steele
Karen Grace-Martin
Publication date
01-10-2017
Publisher
Springer US
Published in
Dysphagia / Issue 5/2017
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-017-9809-z

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