E15 What Were We Doing Before? VFSS Reference Values and the Case for Quantitative Measurement with Dr Catriona Steele
Dysphagia Research BitesShow Notes
What if you could interpret a video fluoroscopy report the way a doctor reads a blood test, with clear reference ranges, and the ability to say with confidence whether a value is within or outside what's expected for a healthy adult? That's exactly what Dr Catriona Steele and her team at the University of Toronto have been working on, and in this episode she walks us through what they've found.
In this episode we cover: What prompted the development of VFSS reference values. How the ASPEKT method differs from ordinal rating tools like MBSImP and what it means to measure swallowing rather than describe it What the reference data tells us about residue, and why ASPEKT's approach to measuring residue is conceptually different from the Bolus Clearance Ratio and DIGEST The 2D vs 3D measurement problem: the validity challenges of pixel-based area measures and what Catriona's team is doing about it How many thin fluid swallows you actually need before you can confidently rule out aspiration and whether consecutive sips count Why bolus position at swallow onset was dropped from the reference value framework and what replaced it What emerging ASPEKT data is showing across clinical populations including Parkinson's disease and COPD ASPEKT Academy and the clinical workshop coming to Australia
The publications this episode is based on: Steele, C. M., Peladeau-Pigeon, M., Barbon, C. A. E., Guida, B. T., Tapson, M. S., Valenzano, T. J., & Waito, A. A. (2023). Reference values for videofluoroscopic measures of swallowing: An update. Journal of Speech, Language, and Hearing Research, 66(8), 2758–2773. https://doi.org/10.1044/2023_JSLHR-22-00608
Updated 2026 Reference Values available here: https://figshare.com/s/428ddbd2d1d009abcd01
Register for upcoming ASPEKT VFSS Workshops Here: https://steeleswallowinglab.ca/srrl/education/aspekt-academy/#:~:text=ASPEKT%20Academy%20is%20a%202%2Dday,be%20offered%204%20times.%20The
For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course
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