title: What information do clinicians use in recommending oral versus nonoral feeding in oropharyngeal dysphagic patients?
abstract: 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.
authors.affiliation: Department of Communication Sciences and Disorders, Northwestern University, Frances Searle Building, 2240 Campus Drive, Evanston, Illinois, 60208, USA. j-logemann@northwestern.edu
authors.forename: Jeri A
authors.initials: JA
authors.lastname: Logemann
authors.forename: Alfred
authors.initials: A
authors.lastname: Rademaker
authors.forename: Barbara Roa
authors.initials: BR
authors.lastname: Pauloski
authors.forename: Jodi
authors.initials: J
authors.lastname: Antinoja
authors.forename: Mary
authors.initials: M
authors.lastname: Bacon
authors.forename: Michelle
authors.initials: M
authors.lastname: Bernstein
authors.forename: Joy
authors.initials: J
authors.lastname: Gaziano
authors.forename: Barbara
authors.initials: B
authors.lastname: Grande
authors.forename: Lisa
authors.initials: L
authors.lastname: Kelchner
authors.forename: Amy
authors.initials: A
authors.lastname: Kelly
authors.forename: Bernice
authors.initials: B
authors.lastname: Klaben
authors.forename: Donna
authors.initials: D
authors.lastname: Lundy
authors.forename: Lisa
authors.initials: L
authors.lastname: Newman
authors.forename: Daphne
authors.initials: D
authors.lastname: Santa
authors.forename: Linda
authors.initials: L
authors.lastname: Stachowiak
authors.forename: Carrie
authors.initials: C
authors.lastname: Stangl-McBreen
authors.forename: Cory
authors.initials: C
authors.lastname: Atkinson
authors.forename: Heidi
authors.initials: H
authors.lastname: Bassani
authors.forename: Melissa
authors.initials: M
authors.lastname: Czapla
authors.forename: Julie
authors.initials: J
authors.lastname: Farquharson
authors.forename: Kristin
authors.initials: K
authors.lastname: Larsen
authors.forename: Vicki
authors.initials: V
authors.lastname: Lewis
authors.forename: Heather
authors.initials: H
authors.lastname: Logan
authors.forename: Teri
authors.initials: T
authors.lastname: Nitschke
authors.forename: Sharon
authors.initials: S
authors.lastname: Veis
mesh_terms: 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