Reflections on Clinical and Statistical Use of the Penetration-Aspiration Scale

What is it about?

In this article, we examine the most-commonly used method for measuring the severity of airway invasion during swallowing, the 8-point Penetration-Aspiration Scale (Rosenbek et al., 1996). We review what has been learned over 20 years of using this scale and propose revisions. A statistical tutorial section in the second half of the article shows researchers the strengths and limitations of different approaches to statistical analysis of the penetration-aspiration scale.

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Why is it important?

This article reviews what has been learned over 20 years of use of the main scale for measuring the severity of airway invasion during swallowing (penetration-aspiration). The article calls for a rethinking of the number of levels of severity based on physiological rationale and emphasizes the need to use frequency based statistics for analysis of this data in research.