Simultaneous modified barium swallow and blue dye tests: A determination of the accuracy of blue dye test aspiration findings

The overall objective of this pilot study was to determine blue dye test reliability and validity for the identification of aspiration of secretions, food, and/or drink in 50 simultaneously administered blue dye (BDT) and modified barium swallow (MBS) tests of tracheostomized individuals. With the MBS as an objective test of aspiration, BDT sensitivity and specificity identifying aspiration were less than 80% and 62%, respectively. Certain tracheostomy tube conditions and food consistencies were associated with more accurate BDT aspiration results than others. Characteristics of the aspiration episodes, interpretation of the results, and needs for further research are discussed.