{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T10:45:40Z","timestamp":1782470740601,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective(s)<\/jats:title>\n                    <jats:p>To determine whether cervical auscultation (CA) provides a high\u2010specificity, rule\u2010in bedside signal to prioritize fiberoptic endoscopic evaluation of swallowing (FEES) in adults at risk of aspiration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single\u2010center, cross\u2010sectional diagnostic\u2010accuracy study in a tertiary hospital. Adults referred for clinically indicated swallow evaluation underwent the same\u2010session, mutually blinded CA (index) and FEES (reference). The unit of analysis was the individual bolus; each bolus received paired CA and FEES ratings. We estimated sensitivity, specificity, predictive values, likelihood ratios (LR\u00b1), diagnostic odds ratio (DOR), and area under the ROC curve (AUC), with 95% confidence intervals; McNemar's test compared paired classifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010two adults contributed 256 analyzable boluses (aspiration prevalence 19.5%). CA sensitivity was 62.0% and specificity 99.5%, with accuracy 92.2%, PPV 96.9%, and NPV 91.5%. LR+\u2009=\u2009127.7 and LR\u2212\u2009=\u20090.38; DOR\u2009=\u2009334.5; AUC\u2009=\u20090.808. McNemar's test (FP\u2009=\u20091 vs. FN\u2009=\u200919) was significant, indicating more false negatives than false positives. At pretest probabilities of 10%, 20%, and 40%, a CA\u2010positive result yielded post\u2010test probabilities of 93.4%, 97.0%, and 98.8%, respectively; CA\u2010negative results yielded post\u2010test probabilities of 4.1%, 8.7%, and 20.3%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CA offers a high\u2010specificity rule\u2010in signal to triage and prioritize FEES rather than to exclude aspiration. Integrating CA into dysphagia pathways may improve access to instrumental assessment while maintaining safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>2 (Diagnosis).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70448","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T03:57:01Z","timestamp":1779681421000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Accuracy of Cervical Auscultation for Aspiration Detection in Adult Dysphagia: Implications for\n                    <scp>FEES<\/scp>\n                    Prioritization"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1853-0398","authenticated-orcid":false,"given":"Nisreen Naser","family":"Al Awaji","sequence":"first","affiliation":[{"name":"Department of Health Communication Sciences College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7895-7422","authenticated-orcid":false,"given":"Abdullah Mohammed","family":"Alfaris","sequence":"additional","affiliation":[{"name":"Rehabilitation Department King Abdullah Bin Abdulaziz University Hospital  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaden Abdulmohsen","family":"Alabdulkarim","sequence":"additional","affiliation":[{"name":"Rehabilitation Department King Abdullah Bin Abdulaziz University Hospital  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lama","family":"Al Bashir","sequence":"additional","affiliation":[{"name":"Department of Community Health Faculty of Medicine, Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wajd Dhafer","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"Department of Health Communication Sciences College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haya Saleh","family":"Aldahmash","sequence":"additional","affiliation":[{"name":"Department of Health Communication Sciences College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawan Yahya","family":"Alshareef","sequence":"additional","affiliation":[{"name":"Department of Health Communication Sciences College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara Nawaf","family":"Almutairi","sequence":"additional","affiliation":[{"name":"Department of Health Communication Sciences College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawabi Mesfer","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"Department of Health Communication Sciences College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajar Abdulaziz","family":"Almuqrin","sequence":"additional","affiliation":[{"name":"Department of Health Communication Sciences College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Pediatric Swallowing and Feeding: Assessment and Management","author":"Arvedson J. 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