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Dysphagia
Published in: Dysphagia 4/2020

01-08-2020 | Foreign Body Aspiration | Original Paper

Use of the Penetration-Aspiration Scale in Dysphagia Research: A Systematic Review

Authors: James C. Borders, Danielle Brates

Published in: Dysphagia | Issue 4/2020

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Abstract

The penetration-aspiration scale (PAS) is an 8-point scale used to characterize the depth and response to airway invasion during videofluoroscopy. Though widely used in the field of deglutition, there is a lack of consensus regarding the statistical properties of the scale. In order to better understand the state of the literature and the statistical use of the PAS, a systematic review was undertaken to descriptively examine trends in statistical and reporting practices of the PAS since its inception. Online databases were searched for studies citing the original PAS article, which yielded 754 unique articles. Of these, 183 studies were included in the review. Results showed inconsistencies in the statistical use of the scale; 79 studies treated the PAS as ordinal, 71 as categorical, and 49 as interval. Ten types of categorizations were identified. Reporting of power analyses (9%), as well as inter- (26%) and intra-rater (17%) reliability, was uncommon. Among studies that administered multiple bolus volumes or consistencies, 55% reported PAS analyses at the participant/group level only. This review confirms the existence of discrepancies in the statistical treatment of the PAS. A lack of consensus among researchers limits comparisons between studies. The approach to handling this scale dictates the statistical tests used, potentially affecting results and interpretations. Consistent application of statistically sound approaches to PAS analyses is vital for the future of deglutition research.
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Metadata
Title
Use of the Penetration-Aspiration Scale in Dysphagia Research: A Systematic Review
Authors
James C. Borders
Danielle Brates
Publication date
01-08-2020
Publisher
Springer US
Published in
Dysphagia / Issue 4/2020
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-019-10064-3

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