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Chapter 3
Fourth, the study was not powered to determine normal values or cut-off values, as this was beyond the scope of the study. Therefore, future studies including larger samples of healthy participants and dysphagia patients are needed to establish such values.
Fifth, as thick liquid, we did not use a texture from daily life, such as yoghurt for example, because that might reduce reproducibility given the variability of the consistency between types, brands, and production day.
Sixth, patients were merely asked to provide feedback on how they experienced performing the SPEAD-test. In order to further clarify patients’experience and suggestions for development of the test, future studies could use more elaborate and formal methods, such as focus groups. Seventh, during the SPEAD-test, the patient is observed during swallowing and, as with any observer administered test, this may impact on performance to a certain extent.
CONCLUSION
The SPEAD-test measured (safe) swallowing capacity (in grams per second) by means of a timed bolus ingestion of three consistencies (i.e., thin liquid, thick liquid and solid) and has proven to be safe and feasible with good reliability and validity. It is an easily accessible test, requiring minimal equipment, time, and money. The test can be used to objectify, evaluate and monitor swallowing capacity in HNC patients, in both research as well as daily clinical practice. Future studies should be performed to further validate the SPEAD-test, and determine normal values and cut-off values in larger populations.
ACKNOWLEDGEMENTS
Michelle Hagemeijer is acknowledged for her support in performing the SPEAD-test in a significant proportion of the healthy participants.