# Effect of Thickened Feeds on Swallow Physiology and Clinical Outcomes in Children with Brief Resolved Unexplained Event

> **NIH NIH K23** · BOSTON CHILDREN'S HOSPITAL · 2022 · $194,100

## Abstract

PROJECT SUMMARY
 Brief resolved unexplained events (BRUE) are frightening episodes characterized by appearance of
life-threatening choking, cyanosis, and limpness in infants. These common events are resource-intensive and
current management inadequately addresses persistent symptoms. Infants with BRUE commonly have
oropharyngeal dysphagia with aspiration, which is a modifiable risk factor for persistent symptoms, but there
are no studies determining the mechanism behind this swallow dysfunction and if swallow interventions reduce
morbidity. Systematic investigation of the contribution of oropharyngeal dysphagia to disease burden in this
population is urgently needed, as this approach has vast potential to optimize clinical outcomes, improve
quality of life and reduce healthcare utilization. Daniel Duncan, MD MPH is an Instructor at Harvard Medical
School (HMS) and a subspecialist within the Aerodigestive Center at Boston Children’s Hospital (BCH). He has
gained substantial clinical research experience during his medical training and has demonstrated commitment
to an academic career in patient oriented research. His career goal is to direct a clinical research program
focused on identifying evidenced-based, state of the art interventions for oropharyngeal dysphagia and
aerodigestive disorders that transform clinical care for this vulnerable pediatric population.
 This Career Development Award will provide additional mentored training and research opportunities in
high resolution impedance-manometry and decision analysis for Dr. Duncan to advance his quantitative
research skills while addressing the current knowledge gap related to mechanisms of swallow dysfunction in
BRUE. The proposed innovative studies will systematically determine mechanisms by which thickened feeds
modulate swallow function and confirm these findings in a larger cohort, which will allow for derivation of an
improved algorithm for BRUE care. He will study effects of alterations in liquid viscosity on upper esophageal
motility using pharyngeal impedance-manometry, follow a prospective cohort to determine predictors of
response to thickening, and use decision analysis to identify patients that could receive empiric thickening.
 The mentorship and scientific training afforded by this career development award will be critical for Dr.
Duncan’s academic development. His primary mentor, Dr. Rosen, is an aerodigestive expert. His co-mentors,
Drs. Jadcherla and Omari, are experts in neonatal swallow dysfunction and impedance-manometry; all are
outstanding clinical researchers with deep commitment to mentorship. He will be supported by his Scholarship
Advisory Committee consisting of Drs. Snapper, Nurko, Landrigan, and Stamoulis, who lend content-area
expertise. His formal training includes advanced coursework in decision analysis at Harvard School of Public
Health, personal instruction on esophageal motility and decision analysis, and professional development
courses. His training and r...

## Key facts

- **NIH application ID:** 10378554
- **Project number:** 5K23DK127251-02
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Daniel R. Duncan
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $194,100
- **Award type:** 5
- **Project period:** 2021-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10378554

## Citation

> US National Institutes of Health, RePORTER application 10378554, Effect of Thickened Feeds on Swallow Physiology and Clinical Outcomes in Children with Brief Resolved Unexplained Event (5K23DK127251-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10378554. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*