1. Name Jodi Allen & Laura Sinnott
Affiliation Heart of England NHS Foundation Trust
Lay summary
We are comparing the ability of trained SLT clinicians to accurately hypothesise underlying pathophysiology of a patient’s dysphagia using bedside clinical methods. We aim to do this by comparing the hypothesis formed at the bedside with outcomes of an objective videofluoroscopy assessment.
We also aim to identify whether these outcomes are affected by:
i) clinician experience and/or ii) underlying patient diagnosis. We will also consider whether certain element(s) of the bedside examination are better at predicting underlying pathophysiology than others.
Question/Rationale
To what extent can trained clinicians identify underlying dysphagia pathophysiology in the acute hospital population using clinical bedside assessment?
What did you do?
Provide a descriptive overview of the findings
Use statistical methods to:
1) Ascertain the significance of
i) experience and ii) patient diagnosis on
the ability of the clinician to predict
impairment accurately
2) Identify the strongest predictors of dysphagia
impairment used in bedside assessment
Access clinician hypotheses of underlying dysphagia impairment from clinical records & collate onto a summary sheet.
Compare clinical hypotheses with peer-reviewed videofluoroscopy findings.
What did you find out?
This project is currently underway. Data will be collected over a period of 12 months before findings are collated and tested statisically. We hypothesise that clinicians with experience conducting and interpreting objective examinations on a routine basis may be better at predicting underlying impairment at bedside. We also predict that clinicians may be better at hypothesising underlying impairment in patients with certain neurological conditions (such as Stroke) than other conditions.
Next steps:
Continued collection of data
Statistical analysis
Write up & dissemination
Implications:
Findings may influence the way in which SLT access objective swallowing examination in the acute hospital setting. It may support the need for further research in this area.