Videofluoroscopy is one of the main instrumental tools used to assess swallowing biomechanics and physiology. In the UK, it is mainly within the remit of speech and language therapists (SLT) to perform videoswallows but there is considerable variability in both how the procedure is conducted and the way in which results are presented and interpreted. This paper provides the results of a web-based survey which captured practice in 73/135 acute NHS Trusts (54.8%) and 101 separate videofluoroscopy clinics between October 2018 and January 2019. Significant findings included the following: the majority of clinics were SLT led with radiographer support (74% ) with just under half of radiographers having received specialist training in videofluoroscopy. A radiologist was only reported to be present in 28% of clinics (mainly in those with just one SLT) although radiologists were usually available to review images later if required (86%). Less than half of clinics reported using a standard assessment protocol (47%) whilst a little over half (56%) used a standard analysis protocol, but up to a quarter of these did not use the protocol consistently. Technical aspects of frame rate acquisition, screening time, image quality, and knowledge of contrast material all showed much variation. The authors highlight that only some of the National Videofluoroscopy guidelines have been implemented in UK clinics and call for more collaborative work with all stakeholders to create more detailed and updated operational guidelines. This together with relevant training is important to ensure accurate and reliable results from videofluoroscopy. Furthermore, as videofluoroscopy is increasingly used to generate outcome measures in large often expensive clinical trials, it is imperative for both clinicians and researchers to feel confident in performing the procedure and the results generated.
All videoswallows are not performed equally…
Reviewed by Roganie Govender
The Landscape of Videofluoroscopy in the UK: A Web-Based Survey.
CONTRIBUTOR
Roganie Govender
University College London, Head & Neck Academic Centre, UK.
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