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The development of a dysphagia screening tool: a multidisciplinary approach

Authors: Mandysová Petra | Ehler Edvard | Pellant Arnošt | Škvrňáková Jana | Černý Michal | Bártová Iva

Year: 2014

Type of publication: ostatní - článek ve sborníku

Page from-to: 51-51

Titles:

Language	Name	Abstract	Keywords
eng	The development of a dysphagia screening tool: a multidisciplinary approach	by comparing the results of physical examination (PE) with flexible endoscopic examination of swallowing (FEES) as the gold standard. The original study included a heterogeneous group of patients. In contrast, the aim of the current study was to develop a neurological NDST by conducting a separate analysis of the results for the neurological subgroup. Priority was placed on achieving high sensitivity and negative predictive value (NPV). Materials-Methods: Study participants included a purposive sample of patients with a neurological diagnosis and a potential risk of dysphagia (n = 112). The patients underwent PE (32 items) by a trained nurse and FEES by a physician. The results were dichotomized (normal versus abnormal) and compared using the phi coefficient. PE items demonstrating a statistically significant relationship with FEES (p-value < 0.05) were included in the screening tool if they contained < 5% of missing values. For each item, the score was 0 (normal) or 1 point (abnormal). The total score was the sum of the points. The diagnostic parameters of the tool were calculated for each possible cut-off score. Results: Eight PE items met the above criteria. Therefore, they were combined into a screening test (the total score could range from 0–8 points). The best cut-off score was 1 as it produced the highest sensitivity (95.5%; 95% confidence interval [CI] = 84.9–98.7) and NPV (88.9%; 95% CI = 67.2–96.9). Conclusion: Sensitivity and NPV of the tool are high and are comparable with other, frequently cited NSDT. The size of the sample was sufficiently large as it permitted a sufficiently narrow estimation of the 95% CI. The tool is simple and is suitable for nurse-led dysphagia screening in neurological departments.	dysphagia; FEES; neurological; nursing; screening tool