Accuracy of Dysphagia Screening by Non-clinical Research Staff in the Emergency Department.

3 Ounce Water Swallow Test Aspiration Pneumonia Emergency Department Screening TOR-BSST©

Journal

Dysphagia
ISSN: 1432-0460
Titre abrégé: Dysphagia
Pays: United States
ID NLM: 8610856

Informations de publication

Date de publication:
30 May 2024
Historique:
received: 12 02 2024
accepted: 11 04 2024
medline: 31 5 2024
pubmed: 31 5 2024
entrez: 30 5 2024
Statut: aheadofprint

Résumé

Although the emergency department (ED) is the initial care setting for the majority of older adults requiring hospital admission, there is a paucity of ED-based dysphagia research in this at-risk population. This is driven by barriers to dysphagia evaluation in this complex care environment. Therefore, we assessed the reliability of trained, non-clinical ED research staff in administering dysphagia screening tools compared to trained speech pathologists (SLPs). We also aimed to determine perceptual screening discrepancies (e.g. voice change) between clinical and non-clinical staff. Forty-two older adults with suspected pneumonia were recruited during an ED visit and underwent dysphagia (Toronto Bedside Swallow Screening Tool; TOR-BSST©) and aspiration (3-oz water swallow test; 3-oz WST) screening by trained non-clinical research staff. Audio-recordings of screenings were re-rated post-hoc by trained, blinded SLPs with discrepancies resolved via consensus. Cohen's kappa (unweighted) revealed moderate agreement in pass/fail ratings between clinical and non-clinical staff for both the TOR-BSST© (k = 0.75) and the 3 oz WST (k = 0.66) corresponding to excellent sensitivity and good specificity for both the TOR-BSST (SN = 94%, SP = 85%) and the 3 oz WST (SN = 90%, SP = 81%). Further analysis of TOR-BSST perceptual parameters revealed that most discrepancies between clinicians and non-clinicians resulted from over-diagnosis of change in vocal quality (53%). These results support the feasibility of non-clinical research staff administering screening tools for dysphagia and aspiration in the ED. Dysphagia screening may not necessitate clinical staff involvement, which may improve feasibility of large-scale ED research. Future training of research staff should focus on perceptual assessment of vocal quality.

Identifiants

DOI: 10.1007/s00455-024-10710-5 PMID: 38816522
pubmed: 38816522
doi: 10.1007/s00455-024-10710-5
pii: 10.1007/s00455-024-10710-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Ryan J Burdick (RJ)

Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI, 53705-2281, USA. rjburdick@wisc.edu.
Geriatrics Research Education and Clinical Center (GRECC), William S Middleton Veterans Hospital, 2500 Overlook Terrace, Madison, WI, 53705, USA. rjburdick@wisc.edu.
Department of Communication Sciences and Disorders, University of Wisconsin-Madison, 1975 Willow Dr, Madison, WI, 53706, USA. rjburdick@wisc.edu.
ORCID: 0000-0003-0424-0207

Nicole Rogus-Pulia (N)

Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI, 53705-2281, USA.
Geriatrics Research Education and Clinical Center (GRECC), William S Middleton Veterans Hospital, 2500 Overlook Terrace, Madison, WI, 53705, USA.

Rebecca Schwei (R)

BerbeeWalsh Department of Emergency Medicine, University of Wisconsin Madison School of Medicine and Public Health, 800 University Bay Drive, Suite 310, Madison, WI, 53705, USA.
Center for Health Disparities Research, University of Wisconsin, Madison, USA.

Sara Gustafson (S)

Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI, 53705-2281, USA.
Geriatrics Research Education and Clinical Center (GRECC), William S Middleton Veterans Hospital, 2500 Overlook Terrace, Madison, WI, 53705, USA.

Raele Donetha Robison (RD)

Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI, 53705-2281, USA.
Center for Health Disparities Research, University of Wisconsin, Madison, USA.

Rosemary Martino (R)

Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada.
Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
Krembil Research Institute, University Health Network, Toronto, ON, Canada.
Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.
Faculty of Medicine, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada.

Michael Pulia (M)

BerbeeWalsh Department of Emergency Medicine, University of Wisconsin Madison School of Medicine and Public Health, 800 University Bay Drive, Suite 310, Madison, WI, 53705, USA.
Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, USA.

Classifications MeSH