Towards a basic endoscopic evaluation of swallowing in acute stroke - identification of salient findings by the inexperienced examiner.
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.
Warnecke
Tobias
T
Department of Neurology, University Hospital of Münster, Germany. Tobias.Warnecke@ukmuenster.de
Teismann
Inga
I
Oelenberg
Stephan
S
Hamacher
Christina
C
Ringelstein
E Bernd
EB
Schäbitz
Wolf R
WR
Dziewas
Rainer
R
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