Patients & Practice, Policy & Education| Volume 83, P144-151, March 2022

Understanding differences in practices and preferences during videofluoroscopic swallow studies: A survey of radiologists and speech language pathologists in the United States


      • Disparities exist between radiologists and speech-language pathologists in videofluoroscopic swallow study practice patterns.
      • Radiologists and speech-language pathologists agree on the need for a standardized videofluoroscopic swallow study protocol.
      • Disparities that have clear guidance on best practice are: AP view, esophageal sweep, frame rate, and initial aspiration.



      The purpose of this study was to (a) examine the interprofessional relationship between radiologists and speech-language pathologists (SLPs), and (b) explore viewpoints and practice patterns of each profession regarding a videofluoroscopic swallow study (VFSS).


      This IRB approved study utilized an online survey developed by the authors to gather information from radiologists and SLPs who currently perform videofluoroscopic swallow studies (VFSS) for the evaluation of swallow function. Surveys were primarily distributed through the American Speech-Language-Hearing Association's (ASHA) Special Interest Group 13 (Swallowing and Swallowing Disorders) forum, through LinkedIn and email networking among professional radiology-focused businesses and organizations (Bracco Diagnostics, Inc., Society of Abdominal Radiology), and via social media (e.g. Facebook). The survey consisted of 7 demographic questions and 15 practice-related items, using a modified Likert scale and multiple-choice items to assess agreement with statements regarding VFSS procedures and opinions on professional roles.


      Radiologists and SLPs differed significantly (p < 0.05) in practices regarding nearly all items surveyed, including preferences on: esophageal sweep, anteroposterior view, fluoroscopy time limitation, termination following an aspiration event, frame rate, as well as in defining the primary role of the SLP, the primary purpose of a VFSS, the most valuable piece of information obtained from a VFSS, and training requirements. Radiologists and SLPs agreed that a standardized protocol should exist for VFSS.


      Radiologists and SLPs differ in their practice patterns and opinions on the roles of team members in the performance of VFSS. However, both radiologists and SLPs agree that a standardized protocol for VFSS should exist.


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