# The Aspirometer: A noninvasive tool to detect swallowing safety and efficiency

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $350,218

## Abstract

ABSTRACT
Impaired swallowing (oropharyngeal dysphagia or OPD) causes nearly 150,000 annual hospitalizations and
over 220,000 additional hospital days, and prolongs hospital lengths of stay by 40%. OPD risk is typically
identified through subjective standard institutional screening (SIS) protocols and those identified through
screening undergo gold standard imaging testing such as videofluoroscopy (VF). However, SIS methods over-
or underestimate risk, and completely fail to identify patients with silent OPD who silently aspirate food into
their lungs, raising their risk of pneumonia and other adverse events. Pre-emptive detection of silent or near-
silent aspiration is essential. Our long-term goal is to develop an instrumental dysphagia screening approach
based on high-resolution cervical auscultation (HRCA) to accurately predict OPD-related adverse events, and
initiate more timely intervention measures to mitigate them. The overall objective here is to develop accurate,
advanced data analysis approaches to translate HRCA signals to swallowing events observed in VF images.
Our strong preliminary data has led us to our central hypothesis: HRCA coupled with advanced data analytics
tools are powerful approaches to automate and improve existing dysphagia screening protocols. The rationale
is that a reliable, robust early-warning instrumental OPD screening approach will reduce adverse events in
patients with silent aspiration/dysphagia, shorten length of stay, reduce cost, and improve patient health.
Guided by strong preliminary data, we will pursue the following three specific aims: (1) define HRCA signal
signatures that characterize the entire continuum swallowing safety from unimpaired to severely impaired; (2)
translate HRCA swallow signal signatures and equate them to validated measures of swallowing impairment;
and (3) prospectively assess the effectiveness of our HRCA system in predicting clinically significant OPD and
aspiration in a randomized, controlled trial. Under the first aim, we will collect HRCA swallow signatures from
unimpaired people, and combine and analyze them along with our large database of swallows of people with
OPD to characterize the entire range of swallowing function from unimpaired through severe OPD. Under the
second aim, we will develop HRCA OPD severity cutoffs and match them to gold standard derived OPD
impairment cutoffs to establish HRCA’s ability as a diagnostic surrogate that differentiates clinically significant
OPD and aspiration from benign swallowing impairments. Under the third aim, we will test HRCA in a clinical
setting by deploying HRCA with consenting patients, and comparing the accuracy of independent HRCA,
independent SIS, and HRCA+SIS to VF data from all participants. The approach is innovative, as it will
combine technology with clinical judgment to shift the OPD screening paradigm and fundamentally improve
efforts to reduce morbidity and mortality caused by OPD. Our work is significant, because it...

## Key facts

- **NIH application ID:** 9995530
- **Project number:** 5R01HD074819-06
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** James L Coyle
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $350,218
- **Award type:** 5
- **Project period:** 2013-07-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9995530

## Citation

> US National Institutes of Health, RePORTER application 9995530, The Aspirometer: A noninvasive tool to detect swallowing safety and efficiency (5R01HD074819-06). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9995530. Licensed CC0.

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