title: Towards a basic endoscopic evaluation of swallowing in acute stroke - identification of salient findings by the inexperienced examiner.
abstract: BACKGROUND
  Dysphagia is common after stroke. Fiberoptic endoscopic evaluation of swallowing (FEES) is a powerful tool for dysphagia assessment. The purpose of this study was to assess whether a previously established endoscopic examination protocol based on the identification of typical findings indicative of stroke - related dysphagia may be learned and adopted by clinicians so far inexperienced in this field.
  
  
  METHODS
  After receiving a structured lecture on this topic, participants were asked to rate video sequences of endoscopic swallowing examinations of acute stroke patients. The first part of the testing ("single findings-rating") comprised of 16 single sequences, the second part ("complete examination-rating") presented the key sequences of 8 complete examinations. Before the second part was started, results of the first were discussed.
  
  
  RESULTS
  At the "single findings-rating" 88.8% of video-sequences were assessed correctly, while at the "complete examination-rating" the average performance had improved to 96%. Furthermore, no overlooking of relevant pathologies was noted in the second part of the testing.
  
  
  CONCLUSIONS
  This study suggests that the presented endoscopic examination protocol is reliably interpreted by inexperienced clinicians after a short lecture and may therefore easily and successfully be adopted in dysphagia management of acute stroke care.
authors.affiliation: Department of Neurology, University Hospital of Münster, Germany. Tobias.Warnecke@ukmuenster.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Warnecke
authors.forename: Inga
authors.initials: I
authors.lastname: Teismann
authors.forename: Stephan
authors.initials: S
authors.lastname: Oelenberg
authors.forename: Christina
authors.initials: C
authors.lastname: Hamacher
authors.forename: E Bernd
authors.initials: EB
authors.lastname: Ringelstein
authors.forename: Wolf R
authors.initials: WR
authors.lastname: Schäbitz
authors.forename: Rainer
authors.initials: R
authors.lastname: Dziewas
mesh_terms: D000328:Adult; D002983:Clinical Competence; D002985:Clinical Protocols; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D004521:Educational Measurement / Q000379:methods; D004724:Endoscopy / Q000193:education* / Q000379:methods / Q000592:standards; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007828:Laryngoscopy / Q000379:methods / Q000592:standards; D008297:Male; D009462:Neurology / Q000193:education* / Q000592:standards; D015588:Observer Variation; D015203:Reproducibility of Results; D053120:Respiratory Aspiration / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D012463:Saliva / Q000378:metabolism; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D014741:Video Recording