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Dysphagia
Published in: Dysphagia 6/2022

Open Access 24-02-2022 | Ultrasound | Original Article

Translating Ultrasound into Clinical Practice for the Assessment of Swallowing and Laryngeal Function: A Speech and Language Pathology-Led Consensus Study

Authors: Jodi E. Allen, Gemma Clunie, Joan K.-Y. Ma, Margaret Coffey, Katharina Winiker, Sally Richmond, Soren Y. Lowell, Anna Volkmer

Published in: Dysphagia | Issue 6/2022

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Abstract

Ultrasound (US) has an emerging evidence base for the assessment of swallowing and laryngeal function. Accessibility and technological advances support the use of US as a clinical assessment tool; however, there is insufficient evidence to support its translation into clinical practice. This study aimed to establish consensus on the priorities for translation of US into clinical practice for the assessment of swallowing and laryngeal function. Nominal Group Technique (NGT) was used as a formal method of consensus development. Clinicians and academics, all members of an international US working group, were invited to participate in the study. Two NGT meetings were held, where participants silently generated and then shared ideas. Participants anonymously ranked items. Rankings were aggregated before participants re-ranked items in order of priority. Discussions regarding rankings were recorded and transcribed to inform analysis. Member-checking with participants informed the final analysis. Participants (n = 15) were speech and language pathologists, physiotherapists and sonographers representing six countries. Fifteen items were identified and prioritised 1–13 (including two equally ranked items). Reliability, validity and normative data emerged as key areas for research while development of training protocols and engagement with stakeholders were considered vital to progressing US into practice. Analysis revealed common themes that might be addressed together in research, in addition to the ranked priority. A measured approach to the translation of US into clinical practice will enable effective implementation of this tool. Priorities may evolve as clinical and professional contexts shift, but this study provides a framework to advance research and clinical practice in this field.
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Literature
1.
Allen JE, Clunie GM, Slinger C, Haines J, Mossey-Gaston C, Zaga CJ, et al. Utility of ultrasound in the assessment of swallowing and laryngeal function: a rapid review and critical appraisal of the literature. Int J Lang Commun Disord. 2021;56:174–204.CrossRef
2.
3.
Engel-Hoek LVD, Van Alfen N, De Swart BJM, De Groot IJM, Pillen S. Quantitative ultrasound of the tongue and submental muscles in children and young adults. Muscle Nerve. 2012;46:31–7.CrossRef
4.
Van Den Engel-Hoek L, Lagarde M, Van Alfen N. Ultrasound of oral and masticatory muscles: why every neuromuscular swallow team should have an ultrasound machine: ultrasound of oral and masticatory muscles. Clin Anat. 2017;30:183–93.CrossRef
5.
Macrae PR, Jones RD, Myall DJ, Melzer TR, Huckabee M-L. Cross-sectional area of the anterior belly of the digastric muscle: comparison of MRI and ultrasound measures. Dysphagia. 2013;28:375–80.PubMedCrossRef
6.
da Costa BOI, de Rodrigues SBD, Santos AS, Pernambuco L. Transcutaneous laryngeal ultrasonography for the assessment of laryngeal function after thyroidectomy: a review. Ear Nose Throat J. 2021;100:439–46.PubMedCrossRef
7.
Noel JE, Orloff LA, Sung K. Laryngeal evaluation during the COVID-19 pandemic: transcervical laryngeal ultrasonography. Otolaryngol Head Neck Surg. 2020;163:51–3.PubMedCrossRef
8.
Peng CL, Jost-Brinkmann PG, Miethke RR, Lin CT. Ultrasonographic measurement of tongue movement during swallowing. J Ultrasound Med. 2000;19:15–20.PubMedCrossRef
9.
Kim J-H, Kim M-S. Lateral pharyngeal wall motion analysis using ultrasonography in stroke patients with dysphagia. Ultrasound Med Biol. 2012;38:2058–64.PubMedCrossRef
10.
Morinière S, Hammoudi K, Marmouset F, Bakhos D, Beutter P, Patat F. Ultrasound analysis of the upper esophageal sphincter during swallowing in the healthy subject. Eur Ann Otorhinolaryngol Head Neck Dis. 2013;130:321–5.PubMedCrossRef
11.
da Costa BOI, de Rodrigues SBD, de Magalhães DDD, Santos AS, Santos RV, Azevedo EHM, et al. Quantitative ultrasound assessment of hyoid bone displacement during swallowing following thyroidectomy. Dysphagia. 2021;36:659–69.PubMedCrossRef
12.
Hsiao M-Y, Chang Y-C, Chen W-S, Chang H-Y, Wang T-G. Application of ultrasonography in assessing oropharyngeal dysphagia in stroke patients. Ultrasound Med Biol. 2012;38:1522–8.PubMedCrossRef
13.
14.
15.
Yabunaka K, Sanada H, Sanada S, Konishi H, Hashimoto T, Yatake H, et al. Sonographic assessment of hyoid bone movement during swallowing: a study of normal adults with advancing age. Radiol Phys Technol. 2011;4:73–7.PubMedCrossRef
16.
Huang Y-L, Hsieh S-F, Chang Y-C, Chen H-C, Wang T-G. Ultrasonographic evaluation of hyoid-larynx approximation in dysphagic stroke patients. Ultrasound Med Biol. 2009;35:1103–8.PubMedCrossRef
17.
Kuhl V, Eicke BM, Dieterich M, Urban PP. Sonographic analysis of laryngeal elevation during swallowing. J Neurol. 2003;250:333–7.PubMedCrossRef
18.
Allen JE, Clunie GM, Winiker K. Ultrasound: an emerging modality for the dysphagia assessment toolkit? Curr Opin Otolaryngol Head Neck Surg. 2021;29:213–8.PubMedPubMedCentralCrossRef
19.
Feng S, Shea Q-T-K, Ng K-Y, Tang C-N, Kwong E, Zheng Y. Automatic hyoid bone tracking in real-time ultrasound swallowing videos using deep learning based and correlation filter based trackers. Sensors. 2021;21:3712.PubMedPubMedCentralCrossRef
20.
Miura Y, Nakagami G, Yabunaka K, Tohara H, Hara K, Noguchi H, et al. Detecting pharyngeal post-swallow residue by ultrasound examination: a case series. Med Ultrason. 2016;18:288.PubMedCrossRef
21.
Miura Y, Nakagami G, Yabunaka K, Tohara H, Noguchi H, Mori T, et al. A randomized controlled trial to investigate the effectiveness of the prevention of aspiration pneumonia using recommendations for swallowing care guided by ultrasound examination. Healthcare. 2018;6:15.PubMedCentralCrossRef
22.
Miura Y, Yabunaka K, Karube M, Tsutaoka T, Yoshida M, Matsumoto M, et al. Establishing a methodology for ultrasound evaluation of pharyngeal residue in the pyriform sinus and epiglottic vallecula. Respir Care. 2020;65:304–13.PubMedCrossRef
23.
Beale T, Twigg VM, Horta M, Morley S. High-resolution laryngeal us: imaging technique, normal anatomy, and spectrum of disease. Radiographics. 2020;40:775–90.PubMedCrossRef
24.
25.
European Society of Radiology (ESR). ESR statement on portable ultrasound devices. Insights Imaging. 2019;10:89.
26.
Hayward S, Smith M, Innes S. Diagnostic thoracic ultrasound imaging: an exploration of respiratory physiotherapists’ interest and use in clinical practice: a national survey. Ultrasound. 2020;28:14–22.PubMedCrossRef
27.
Innes S, Jackson J. Musculoskeletal ultrasound imaging: an exploration of physiotherapists’ interests and use in practice. Musculoskelet Sci Pract. 2019;44:102068.PubMedCrossRef
28.
Pradeep Albert, Martin Wendelken, Kenneth Meisler, Ramy Elattal. Diagnostic ultrasound in the modern podiatric practice. Podiatry Management. 2017;79–90.
29.
Hayward S, Innes S, Smith M. Challenges and opportunities in point-of-care ultrasound: a qualitative exploration of respiratory physiotherapists’ experiences of lung ultrasound training and its adoption in critical care. Ultrasound. 2021;1742271X2110341.
30.
31.
Pisegna JM, Langmore SE. Parameters of instrumental swallowing evaluations: describing a diagnostic dilemma. Dysphagia. 2016;31:462–72.PubMedCrossRef
32.
Swan K, Cordier R, Brown T, Speyer R. Psychometric properties of visuoperceptual measures of videofluoroscopic and fibre-endoscopic evaluations of swallowing: a systematic review. Dysphagia. 2019;34:2–33.PubMedCrossRef
33.
34.
Martin-Harris B, Brodsky MB, Michel Y, Castell DO, Schleicher M, Sandidge J, et al. MBS measurement tool for swallow impairment—MBSImp: establishing a standard. Dysphagia. 2008;23:392–405.PubMedPubMedCentralCrossRef
35.
Miller CK, Schroeder JW, Langmore S. Fiberoptic endoscopic evaluation of swallowing across the age spectrum. Am J Speech Lang Pathol. 2020;29:967–78.PubMedCrossRef
36.
37.
Bauer MS, Kirchner J. Implementation science: what is it and why should I care? Psychiatry Res. 2020;283:112376.PubMedCrossRef
38.
Murray E, Treweek S, Pope C, MacFarlane A, Ballini L, Dowrick C, et al. Normalisation process theory: a framework for developing, evaluating and implementing complex interventions. BMC Med. 2010;8:63.PubMedPubMedCentralCrossRef
39.
Huddlestone L, Turner J, Eborall H, Hudson N, Davies M, Martin G. Application of normalisation process theory in understanding implementation processes in primary care settings in the UK: a systematic review. BMC Fam Pract. 2020;21:52.PubMedPubMedCentralCrossRef
40.
May CR, Cummings A, Girling M, Bracher M, Mair FS, May CM, et al. using normalization process theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review. Implement Sci. 2018;13:80.PubMedPubMedCentralCrossRef
41.
42.
Partridge N, Scadding J. The james lind alliance: patients and clinicians should jointly identify their priorities for clinical trials. Lancet. 2004;364:1923–4.PubMedCrossRef
43.
44.
Hinckley J, Boyle E, Lombard D, Bartels-Tobin L. Towards a consumer-informed research agenda for aphasia: preliminary work. Disabil Rehabil. 2014;36:1042–50.PubMedCrossRef
45.
Wallace SJ, Worrall L, Rose T, Le Dorze G. Which treatment outcomes are most important to aphasia clinicians and managers? An international e-Delphi consensus study. Aphasiology. 2017;31:643–73.CrossRef
46.
47.
Bolton L, Mills C, Wallace S, Brady MC, Royal College of Speech and Language Therapists (RCSLT) COVID‐19 Advisory Group. Aerosol generating procedures, dysphagia assessment and COVID-19: a rapid review. Int J Lang Commun Disorders. 2020;55:629–36.CrossRef
48.
Delbecq A, Ven A, Gustafson D. Group techniques for program planning: a guide to nominal group and delphi processes. J Appl Behav Sci. 1976;12:581–581.CrossRef
49.
50.
Harvey N, Holmes CA. Nominal group technique: an effective method for obtaining group consensus: application of nominal group technique. Int J Nurs Pract. 2012;18:188–94.PubMedCrossRef
51.
Finch E, Ward EC, Brown B, Cornwell P, Hill AE, Hill A, et al. Setting a prioritized agenda to drive speech–language therapy research in health. Int J Lang Commun Disord. 2021;56:768–83.PubMedCrossRef
52.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–57.PubMedCrossRef
53.
Tuffrey-Wijne I, Bernal J, Butler G, Hollins S, Curfs L. Using nominal group technique to investigate the views of people with intellectual disabilities on end-of-life care provision. J Adv Nurs. 2007;58:80–9.PubMedCrossRef
54.
55.
Candela A. Exploring the function of member checking. Qualitat Rep. 2019;24:619–28.
56.
57.
Field A, Miles J, Field Z. Discovering statistics using R. London: Sage; 2012.
58.
Portney L, Watkins M. Foundations of clinical research: applications to practice. Pearson/Prentice Hall; 2009.
59.
George K, Batterham A, Sullivan I. Validity in clinical research: a review of basic concepts and definitions. Phys Ther Sport. 2000;1:19–27.CrossRef
60.
Winiker K, Burnip E, Gozdzikowska K, Hernandez EG, Hammond R, Macrae P, et al. Ultrasound: reliability of a pocket-sized system in the assessment of swallowing. J Speech Lang Hear Res. 2021;64:2928–40.PubMedCrossRef
61.
Perry SE, Winkelman CJ, Huckabee M-L. Variability in ultrasound measurement of hyoid bone displacement and submental muscle size using 2 methods of data acquisition. Folia Phoniatr Logop. 2016;68:205–10.PubMedCrossRef
62.
Pucher M, Klingler N, Luttenberger J, Spreafico L. Accuracy, recording interference, and articulatory quality of headsets for ultrasound recordings. Speech Commun. 2020;123:83–97.CrossRef
63.
Nasser HM, Askoura A, Hussein A. Ultrasonography diagnostic validity in structural and functional laryngeal disorders. Egypt J Radiol Nucl Med. 2020;51:219.CrossRef
64.
Wang LM, Zhu Q, Ma T, Li JP, Hu R, Rong XY, et al. Value of ultrasonography in diagnosis of pediatric vocal fold paralysis. Int J Pediatr Otorhinolaryngol. 2011;75:1186–90.PubMedCrossRef
65.
66.
Feng X, Cartwright MS, Walker FO, Bargoil JH, Hu Y, Butler SG. Ultrasonographic evaluation of geniohyoid muscle and hyoid bone during swallowing in young adults: ultrasound during swallowing. Laryngoscope. 2015;125:1886–91.PubMedCrossRef
67.
Garcia-Santibanez R, Dietz AR, Bucelli RC, Zaidman CM. Nerve ultrasound reliability of upper limbs: effects of examiner training: reliability in ultrasound training. Muscle Nerve. 2018;57:189–92.PubMedCrossRef
68.
Nordin NA, Miles A, Allen J. Measuring competency development in objective evaluation of videofluoroscopic swallowing studies. Dysphagia. 2017;32:427–36.PubMedCrossRef
69.
Jones CA, Hoffman MR, Geng Z, Abdelhalim SM, Jiang JJ, McCulloch TM. Reliability of an automated high-resolution manometry analysis program across expert users, novice users, and speech-language pathologists. J Speech Lang Hear Res. 2014;57:831–6.PubMedCrossRef
70.
Mateos González M, de Casasola G, Sánchez G, Muñoz FJT, Proud K, Lourdo D, Sander J-V, et al. Comparison of lung ultrasound versus chest x-ray for detection of pulmonary infiltrates in COVID-19. Diagnostics. 2021;2021(11):373.CrossRef
71.
Drolet BC, Lorenzi NM. Translational research: understanding the continuum from bench to bedside. Transl Res. 2011;157:1–5.PubMedCrossRef
72.
73.
May C, Finch T. Implementing, embedding, and integrating practices: an outline of normalization process theory. Sociology. 2009;43:535–54.CrossRef
74.
Bradshaw A, Santarelli M, Mulderrig M, Khamis A, Sartain K, Boland JW, et al. Implementing person-centred outcome measures in palliative care: an exploratory qualitative study using normalisation process theory to understand processes and context. Palliat Med. 2021;35:397–407.PubMedCrossRef
75.
See KC, Ong V, Tan YL, Sahagun J, Taculod J. Chest radiography versus lung ultrasound for identification of acute respiratory distress syndrome: a retrospective observational study. Crit Care. 2018;22:203.PubMedPubMedCentralCrossRef
76.
Hayward SA, Janssen J. Use of thoracic ultrasound by physiotherapists: a scoping review of the literature. Physiotherapy. 2018;104:367–75.PubMedCrossRef
77.
Karthika M, Wong D, Nair SG, Pillai LV, Mathew CS. Lung ultrasound: the emerging role of respiratory therapists. Respir Care. 2019;64:217–29.PubMedCrossRef
78.
Martin-Harris B, Canon CL, Bonilha HS, Murray J, Davidson K, Lefton-Greif MA. Best practices in modified barium swallow studies. Am J Speech Lang Pathol. 2020;29:1078–93.PubMedPubMedCentralCrossRef
79.
Swan K, Cordier R, Brown T, Speyer R. Visuoperceptual analysis of the videofluoroscopic study of swallowing: an international delphi study. Dysphagia. 2021;36:595–613.PubMedCrossRef
80.
Kwong E, Ng K-WK, Leung M-T, Zheng Y-P. Application of ultrasound biofeedback to the learning of the mendelsohn maneuver in non-dysphagic adults: a pilot study. Dysphagia. 2021;36:650–8.PubMedCrossRef
81.
Cleland J, Scobbie JM, Wrench AA. Using ultrasound visual biofeedback to treat persistent primary speech sound disorders. Clin Linguist Phon. 2015;29:575–97.PubMedCrossRef
82.
Dror IE. Cognitive and human factors in expert decision making: six fallacies and the eight sources of bias. Anal Chem. 2020;92:7998–8004.PubMedCrossRef
83.
Tuffrey-Wijne I, Wicki M, Heslop P, McCarron M, Todd S, Oliver D, et al. Developing research priorities for palliative care of people with intellectual disabilities in Europe: a consultation process using nominal group technique. BMC Palliat Care. 2016;15:36.PubMedPubMedCentralCrossRef
84.
Su E, Hamilton C, Tawfik DS, Mariano K, Ginsburg S, Conlon T, et al. Laryngeal ultrasound detects vocal fold immobility in adults: a systematic review. J Ultrasound Med. 2021;jum.15884.
Metadata
Title
Translating Ultrasound into Clinical Practice for the Assessment of Swallowing and Laryngeal Function: A Speech and Language Pathology-Led Consensus Study
Authors
Jodi E. Allen
Gemma Clunie
Joan K.-Y. Ma
Margaret Coffey
Katharina Winiker
Sally Richmond
Soren Y. Lowell
Anna Volkmer
Publication date
24-02-2022
Publisher
Springer US
Published in
Dysphagia / Issue 6/2022
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-022-10413-9

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