What information do clinicians use in recommending oral versus nonoral feeding in oropharyngeal dysphagic patients?
There is little evidence regarding the type(s) of information clinicians use to make the recommendation for oral or nonoral feeding in patients with oropharyngeal dysphagia. This study represents a first step toward identifying data used by clinicians to make this recommendation and how clinical experience may affect the recommendation. Thirteen variables were considered critical in making the oral vs. nonoral decision by the 23 clinicians working in dysphagia. These variables were then used by the clinicians to independently recommend oral vs. nonoral feeding or partial oral with nonoral feeding for the 20 anonymous patients whose modified barium swallows were sent on a videotape to each clinician. Clinicians also received data on the 13 variables for each patient. Results of clinician agreement on the recommendation of full oral and nonoral only were quite high, as measured by Kappa statistics. In an analysis of which of the 13 criteria clinicians used in making their recommendations, amount of aspiration was the criterion with the highest frequency. Recommendations for use of postures and maneuvers and the effect of clinician experience on these choices were also analyzed.
Logemann
Jeri A
JA
Department of Communication Sciences and Disorders, Northwestern University, Frances Searle Building, 2240 Campus Drive, Evanston, Illinois, 60208, USA. j-logemann@northwestern.edu
Rademaker
Alfred
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Pauloski
Barbara Roa
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Antinoja
Jodi
J
Bacon
Mary
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Bernstein
Michelle
M
Gaziano
Joy
J
Grande
Barbara
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Kelchner
Lisa
L
Kelly
Amy
A
Klaben
Bernice
B
Lundy
Donna
D
Newman
Lisa
L
Santa
Daphne
D
Stachowiak
Linda
L
Stangl-McBreen
Carrie
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Atkinson
Cory
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Bassani
Heidi
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Czapla
Melissa
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Farquharson
Julie
J
Larsen
Kristin
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Lewis
Vicki
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Logan
Heather
H
Nitschke
Teri
T
Veis
Sharon
S
D022126:Access to Information; D002983:Clinical Competence; D003657:Decision Making; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis / Q000503:physiopathology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009960:Oropharynx; D017410:Practice Guidelines as Topic