Abstract 2284: Reliability and Validity of the MGHS Dysphagia Screening Tool for Stroke Patients

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Jeanette Stebelton ◽  
Diane Savolainen ◽  
Margo Carli ◽  
Roxanne Filizetti ◽  
Barb Massey
Keyword(s):  
Screening Tool ◽  
Randomized Study ◽  
Reliability And Validity ◽  
Stroke Patients ◽  
Early Screening ◽  
Rater Reliability ◽  
Speech Language Pathologist ◽  
Significant Difference ◽  
Patients At Risk ◽  
Speech Therapists

Background Dysphagia occurs in approximately 55% of acute stroke patients and is associated with aspiration pneumonia. Clinical practice guidelines recommend that all patients who are admitted with the diagnosis of stroke or suspected stroke should be screened for dysphagia utilizing a validated screening tool prior to receiving any food, fluid, or medication by mouth. Purpose The purpose of the study is to determine the reliability and validity of the Marquette General Health Systems Dysphagia Screen for identifying patients at risk for aspiration. Method This non-randomized study utilized a collaborative tracking tool that compared results of the Nursing Dysphagia Screen (NDS) to the Speech Language Pathologist Swallow Evaluation (SLPSE). Two Registered Nurses rated each patient utilizing the NDS and then the patient was rated on the SLPSE. The NDS includes10 items: and the Speech Language Pathologist portion of the tool consisted of 8 items. Results One hundred subjects ranged in age from 20-94 (M=70.31, SD=14.6). There were more males (n=58) than females (n=42). The majority were admitted to the medical unit (64%), followed by cardiac (14%), ICU (12%) and CCU (10%). Length of stay ranged from 1-15 days (M=3.73, SD=2.8). NIH scores ranged from 0-20 (M=6.8, SD=7.4). Kappa was calculated to determine inter-rater reliability. For 63 pairs of ratings between two staff nurses, Kappa=.81 indicates strong reliability. Scores on the Nursing Dysphagia Screen were compared to 86 Speech Language Pathologist Swallow Evaluations. The Phi Coefficient was not significant indicating that the nurses’ and speech therapists ratings’ were similar. In addition, when there were differences it was false positives by nurses. Conclusion The MGHS NDS is a quick screening tool used by nursing in an effort to prevent aspiration. Prior to implementing the use of the tool, it was important to establish the reliability and validity of the tool. Results indicate that there is strong inter-rater reliability. Validity was established given that there were no significant difference in ratings between the nurses and speech therapists. It appears that the MGHS NDS is an effective early screening tool for dysphagia.

scholarly journals Promoting Healthy Family Behaviors in the Primary Care Setting

PRiMER ◽  
2017 ◽  
Vol 1 ◽  
Author(s):  
Katrina Weirauch ◽  
Julie Phillips
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Usual Care ◽  
Pediatric Obesity ◽  
Screening Tool ◽  
Effective Means ◽  
Randomized Study ◽  
Intervention Group ◽  
Control Group ◽  
Significant Difference

Introduction: Pediatric obesity is an increasingly prevalent problem. Several studies have examined prevention and treatment strategies. The majority of effective studies involved school or community interventions. With health care becoming more collaborative, we hypothesized that a behavioral health specialist may be effective in executing multifaceted interventions with families of at-risk patients. Methods: This is a prospective randomized study, evaluating impact of intervention with a behavioral specialist on lifestyle risk factors for pediatric obesity in children. At-risk behaviors were identified with a screening tool from the Healthy Kids, Healthy Michigan Clinical Decision Tools, based on the 2007 American Academy of Pediatrics guidelines on pediatric obesity. An intervention group received ongoing care from the behavioral specialist over three months, including motivational interviewing and cognitive behavioral therapy. Participants were compared with a control group receiving usual care. Results: There was no significant difference between the intervention and control group regarding change in number of risk factors. However, both groups had a reduced number of risk factors at follow-up. The control group had a significant change in number of risk factors after the intervention. Conclusion: There was no statistically significant difference between the two groups. However, it is notable that both groups saw significant decreases in total number of risk factors. The only addition to usual care provided to the control group was use of the screening tool. Our results indicate that the use of a screening tool and brief physician intervention may be an effective means for improving healthy behaviors within families.

scholarly journals The reliability and validity of a slightly revised Chinese version simplified modified Rankin scale questionnaire

2020 ◽  
Author(s):  
Junliang yuan ◽  
yunxiao wang ◽  
Wenli Hu ◽  
Askiel Bruno
Keyword(s):  
Ischemic Stroke ◽  
Reliability And Validity ◽  
Weighted Kappa ◽  
Chinese Version ◽  
The Novel ◽  
Modified Rankin Scale ◽  
English Version ◽  
Stroke Patients ◽  
Rater Reliability ◽  
Percent Agreement

Abstract Background The slightly revised English version simplified modified Rankin scale questionnaire smRSq(2011) was shown to be reliable, valid, and useful in scoring the modified Rankin scale (mRS) after stroke. Our aim was to assess the inter-rater reliability and validity of a novel Chinese version smRSq(2011). Methods The English version smRSq(2011) was translated into Chinese by a standard process. We recruited 300 consecutive hospitalized ischemic stroke patients in the department of neurology, Beijing Chaoyang Hospital. Six randomly paired raters scored the conventional mRS, the novel Chinese version smRSq(2011), the National Institutes of Health Stroke Scale (NIHSS), and the Barthel index (BI) in-person. Inter-rater reliability and validity were assessed. Results Among the 300 ischemic stroke patients, mean age was 64.9±12.1 years, and 220 (73%) were male. For inter-rater reliability of the smRSq(2011), the percent agreement among the paired raters was 87%, the kappa (κ) was 0.84 (95% CI, 0.79-0.88), and the weighted kappa (κw) was 0.96 (95% CI, 0.95-0.98). The percent agreement between the smRSq(2011) scores by the first rater and the conventional mRS scores by the second rater in each pair was 55%, κ=0.47 (95% CI, 0.40-0.54), and κw=0.91 (95% CI, 0.89-0.93). In construct validity testing, the Spearman’s correlation coefficients comparing the smRSq(2011) scores by the first rater with the NIHSS and the BI scores by the second rater were 0.83 (P<0.001) and -0.86 (P<0.001), respectively. Conclusions Our results show good clinimetric properties of the novel Chinese version smRSq(2011) in scoring the mRS in Chinese stroke patients. Further validation in other clinical settings, including in communities and by remote methods in China is warranted.

scholarly journals The Preventive Effect of Dysphagia Screening on Pneumonia in Acute Stroke Patients: A Systematic Review and Meta-Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1764
Author(s):  
Seoyon Yang ◽  
Yoo Jin Choo ◽  
Min Cheol Chang
Keyword(s):  
Acute Stroke ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Preventive Effect ◽  
Stroke Patients ◽  
Early Screening ◽  
Funnel Plot ◽  
Significant Difference

(1) Background: Dysphagia is common in acute stroke patients and is a major risk factor for aspiration pneumonia. We investigated whether the early detection of dysphagia in stroke patients through screening could prevent the development of pneumonia and reduce mortality; (2) Methods: We searched the PubMed, Embase, Cochrane Library, and Scopus databases for relevant studies published up to November 2021. We included studies that performed dysphagia screening in acute stroke patients and evaluated whether it could prevent pneumonia and reduce mortality rates. The methodological quality of individual studies was evaluated using the Risk Of Bias In Non-randomized Studies of Interventions tool, and publication bias was evaluated by the funnel plot and Egger’s test; (3) Results: Of the 6593 identified studies, six studies met the inclusion criteria for analysis. The screening group had a significantly lower incidence of pneumonia than the nonscreening group did (odds ratio (OR), 0.60; 95% confidence interval (CI), 0.42 to 0.84; p = 0.003; I2, 66%). There was no significant difference in mortality rate between the two groups (OR, 0.61; 95% CI, 0.33 to 1.13; p = 0.11; I2, 93%); (4) Conclusions: Early screening for dysphagia in acute stroke patients can prevent the development of pneumonia.

Factors Affecting the Implementation of Specialized Skills of Therapist in Special Education Centers

2021 ◽  
Vol 15 (8) ◽  
pp. 2107-2112
Author(s):  
Aqsa Mumtaz ◽  
Bareera Saeed ◽  
M. Sikander Ghayas Khan ◽  
Hafsa Noreen ◽  
Rashid H. M ◽  
...  
Keyword(s):  
Special Education ◽  
Sample Size ◽  
Professional Knowledge ◽  
Assessment Tools ◽  
Speech Language Pathologists ◽  
Professional Skills ◽  
Factors Affecting ◽  
Speech Language Pathologist ◽  
Significant Difference ◽  
Speech Therapists

Background: The present study is about the factors affecting the professional skills implementation in special education centers. Speech-language pathologists (SLPs) are responsible for the evaluation and treatment of speech language impediments, however they offer multiple services, such as evaluation and treatment of swallowing problems, impaired cognition, and hearing problems. The failure to maintain an effective professional skills implementation in special education centers so many irreversible, fatal consequences among the speech-language pathologist (SLP). Objectives: To study the factors affecting the implementation of professional skills in special education centers. To conduct comparisons between female and male regarding the implementation of professional skills in special education centers. Method: This observational cross sectional study was conducted in special educational centers of district Lahore, Mandibahudin, Sahiwal, Okara and Shekhupura Punjab, Pakistan. The sample size of this research study was consisting of 73 speech therapists. Age range of participants are 21 to 50 years. There are 61 (81.3%) male participants and 14 (18.7%) female participants sample size as per topic need participate in survey. To draw the sample from population, purposive sampling technique was used. Instrument was developed with the help of the literature review and expert opinion about the topic. Content analysis was done to find out reliability and validity of the questionnaire. Duration of research was nine months from May 2020 to January 2021. Study is approved from the institutional review board of The University of Lahore, Ref No: IRB-UOL-FAHS/745-II/2020. Results: All the factor professional knowledge, Environmental factors affecting professional skills, workload and assessment tools are the positively corralled. The result depicted that significant difference in t (-1.424) p<.000) between the male and female speech-language pathologist. One way ANOVA was used for analysis result showed that there was significant difference (t(198)=-.434 ,sig=.00) among speech therapists responses on the above mentioned factor. Conclusion: Factors affecting the professional skills implementation in special education like availability, professional knowledge, workload, and assessment tools was significantly difference among male and females speech-language pathologist. In future such detailed studies are recommended to further enhance the factors affecting the professional skills implementation in special education centers. There is also need to improve the policies regarding vaccination and its implementations all over the country. Keywords: Professional Skills, Speech-language pathologists (SLPs), Special Education Centers, Gender

Abstract 68: Bedside Dysphagia Screening Tool Validation Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Melissa M Meighan ◽  
Barbara A Schumacher Finnegan ◽  
Noelani C Warren ◽  
Jorge Lipiz ◽  
Mai N Nguyen-Huynh
Keyword(s):  
Screening Tool ◽  
High Sensitivity ◽  
Stroke Care ◽  
Feeding Tube ◽  
Screening Tools ◽  
Point Estimate ◽  
Kappa Score ◽  
Rater Reliability ◽  
Predictive Values ◽  
Speech Language Pathologist

Background: Dysphagia or difficulty swallowing occurs in up to 50% of patients with acute stroke symptoms. Dysphagia screening is considered standard stroke care. Few dysphagia screening tools have been well validated with high sensitivity and specificity. Purpose: The purpose was to validate our system’s dysphagia screening tool. Methods: From August 17, 2015 through September 30, 2015, bedside dysphagia screening was prospectively performed by 2 blinded nurses on all patients age ≥18 years admitted through the emergency department with stroke symptoms at 22 stroke centers in an integrated healthcare system. The tool consisted of three parts: history, physical exam and progressive testing from ice chips to water. A speech language pathologist blinded to the results performed an evaluation on the same patient. Patients with a feeding tube or intubation on arrival, treated with alteplase, or were discharged with a diagnosis other than stroke were excluded from final study analyses. The study quantified the reproducibility of the dysphagia screening tool by computing the percent agreement and kappa score for inter-rater reliability. Validity of dysphagia screening tool was determined using the speech pathologist evaluation as the reference standard. We assessed the sensitivity, specificity, and negative (NPV) and positive predictive values (PPV) for the dysphagia screening tool. The point estimate and 95% confidence interval (CI) were calculated. Results: Dysphagia screening was performed in 726 patients with stroke symptoms. There were 370 patients included in the analysis. Average age was 70 ± 14 years, and 48.2% female. Inter-rater reliability of the dysphagia screen was excellent between both raters at 93.5% agreement (k’= 0.83). The screen performed well when compared to speech language pathologist evaluation, demonstrating both high sensitivity (86.4%, CI: 73.3% to 93.6%) and high NPV (93.6%, CI: 86.8% to 97.0%). Conclusion: Our bedside dysphagia screening tool is highly reliable and valid. The tool had been used in over thirty-five facilities since 2007. The hospital acquired pneumonia rate for ischemic stroke patients has averaged 2-3% a year. This dysphagia screening tool requires minimal training and is easily administered in a timely manner.

scholarly journals Inter-rater reliability and validity of the Action Research arm test in stroke patients

1998 ◽  
Vol 27 (2) ◽  
pp. 107-113 ◽  
Author(s):  
CHING-LIN HSIEH ◽  
I-PING HSUEH ◽  
FU-MEI CHIANG ◽  
PO-HSIN LIN
Keyword(s):  
Action Research ◽  
Reliability And Validity ◽  
Stroke Patients ◽  
Rater Reliability

scholarly journals The reliability and validity of a novel Chinese version simplified modified Rankin scale questionnaire(2011)

2020 ◽  
Author(s):  
Junliang yuan ◽  
yunxiao wang ◽  
Wenli Hu ◽  
Askiel Bruno
Keyword(s):  
Ischemic Stroke ◽  
Reliability And Validity ◽  
Chinese Version ◽  
Chinese Patients ◽  
The Novel ◽  
Modified Rankin Scale ◽  
English Version ◽  
Stroke Patients ◽  
Rater Reliability ◽  
Percent Agreement

Abstract Background The modified Rankin Scale (mRS) is a key global outcome measure after stroke internationally. The latest English version of the simplified modified Rankin scale questionnaire (smRSq)(2011) is a reliable and valid tool in scoring the mRS after stroke. In order to use this tool in Chinese patients, we translated it into Chinese and tested its clinimetric properties. Methods The English version smRSq(2011) was translated into Chinese by a standard process. We recruited 300 consecutive hospitalized ischemic stroke patients in the department of neurology, Beijing Chaoyang Hospital. Six randomly paired raters scored the conventional mRS, the novel Chinese version smRSq(2011), the National Institutes of Health Stroke Scale (NIHSS), and the Barthel index (BI) in-person. Inter-rater reliability and validity were assessed. Results Among the 300 ischemic stroke patients, mean age was 64.9±12.1 years, and 220 (73%) were male. For inter-rater reliability of the smRSq(2011), the percent agreement among the paired raters was 87%, the kappa (κ) was 0.84 (95% CI, 0.79-0.88), and the weighted kappa (κw) was 0.96 (95% CI, 0.95-0.98). The percent agreement between the smRSq(2011) scores and the conventional mRS scores was 55%, κ=0.47 (95% CI, 0.40-0.54), and κw=0.91 (95% CI, 0.89-0.93). In construct validity testing, the Spearman’s correlation coefficients comparing the smRSq(2011) scores with the NIHSS and the BI scores were 0.83 (P<0.001) and -0.86 (P<0.001), respectively. Conclusions Our results show good to excellent clinimetric properties of the novel Chinese version smRSq(2011) in scoring the mRS in Chinese stroke patients. Further validation in other clinical settings, including in communities and by remote methods in China is warranted.

scholarly journals The reliability and validity of body Vision system for assessing posture

2021 ◽  
Vol 9 (1) ◽  
pp. 3-3
Author(s):  
Yaghoub Salekzamani ◽  
Nargess Abolghassemi Fakhree ◽  
Mahzad Azimpouran ◽  
Afshin Ebrahimi ◽  
Hamed Heravi ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Reliability Analysis ◽  
Vision System ◽  
Reliability And Validity ◽  
Cross Sectional Study ◽  
The Body ◽  
Posterior View ◽  
Cross Sectional ◽  
Rater Reliability ◽  
Significant Difference

Introduction Body vision is a novel method which examines postural indices through photogrammetric essentials. Nevertheless, its reliability and validity has not been appraised till now. We aimed to evaluate the reliability and validity of body vision system for posture assessment Methods This was a cross sectional study in which two examiners evaluated photographs of 71 subject using body vision system twice with two-week interval. The Body Vision system involves a Grid wall and a camera fixed in front of the grid wall at about 390 cm distances. Three standing photographs (anterior, right lateral, and posterior view) were captured for participants. Results The results for inter-rater reliability analysis showed most of the parameters (74%) had excellent 95% Confidence Interval (CI), 10 % had good to excellent 95% CI, 13% had moderate to good 95% CI, and 1% had poor to moderate 95% CI (Table 2). The results for intra-rater reliability analysis showed 70-72% of the parameters had excellent 95% Confidence Interval (CI), 6-9% had good to excellent 95% CI, 12-13% had moderate to good 95% CI, and 9% had poor to moderate 95% CI. The comparison between known distances and angles on grid wall and those obtained from photogrammetric measurements showed there is no statistical significant difference (p > 0.05). Also the regression analysis showed there is a significant and positive relationship between them (R2 = 1, p < 0.05). Conclusion The results of this study showed that body vision system is a valid and reliable tool for measuring postural parameters.

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