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神经肌肉疾病患儿吞咽困难和构音障碍的早期检测:医师用筛查清单的诊断准确性。

Early detection of dysphagia and dysarthria in children with neuromuscular disorders: Diagnostic accuracy of a Screeninglist for Physicians.

机构信息

Rehabilitation Centre Klimmendaal, Arnhem, The Netherlands.

Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Rehabilitation, Nijmegen, The Netherlands.

出版信息

J Pediatr Rehabil Med. 2020;13(1):17-23. doi: 10.3233/PRM-180569.

Abstract

PURPOSE

Regardless of age or disease stage, children with neuromuscular disorders (NMD) are at risk of developing dysphagia and/or dysarthria. It is important to screen these children regularly in order to detect and treat problems as soon as possible. To date, there are no standardized tools for screening for dysphagia and dysarthria in children with NMD (pNMD). Thus, children are not always referred for assessment by a speech language therapist (SLT). A new screening instrument for dysphagia and dysarthria has been developed, the Screeninglist Physician of the Diagnostic list for Dysphagia and Dysarthria in pediatric NMD (DDD-pNMD). The diagnostic accuracy was estimated in this study.

METHODS

Sensitivity and specificity were assessed in 131 children aged 2.0-18.0 years by comparing the outcome of the Screeninglist Physician with the diagnosis of dysphagia and/or dysarthria established by an SLT.

RESULTS

The sensitivity of the Screeninglist Physician was 88% and its specificity was 63%. The AUC was 0.83. The prevalence of dysphagia and/or dysarthria was 53%.

CONCLUSION

The Screeninglist Physician of the DDD-pNMD is the first valid screening tool for physicians to identify children with NMD with possible dysphagia and/or dysarthria, thereby enabling timely referral to an SLT.

摘要

目的

无论年龄或疾病阶段如何,患有神经肌肉疾病(NMD)的儿童都有发生吞咽困难和/或构音障碍的风险。定期对这些儿童进行筛查以尽早发现和治疗问题非常重要。迄今为止,尚无用于筛查 NMD 儿童(pNMD)吞咽困难和构音障碍的标准化工具。因此,并非所有儿童都被推荐由言语治疗师(SLT)进行评估。已经开发出一种新的用于筛查吞咽困难和构音障碍的工具,即用于儿科 NMD 吞咽困难和构音障碍的诊断清单的医生筛查清单(DDD-pNMD)。本研究评估了其诊断准确性。

方法

通过比较医生筛查清单的结果与 SLT 确定的吞咽困难和/或构音障碍的诊断,评估了 131 名年龄在 2.0-18.0 岁的儿童的敏感性和特异性。

结果

医生筛查清单的敏感性为 88%,特异性为 63%。AUC 为 0.83。吞咽困难和/或构音障碍的患病率为 53%。

结论

DDD-pNMD 的医生筛查清单是医生识别可能患有吞咽困难和/或构音障碍的 NMD 儿童的首个有效筛查工具,从而能够及时转介给 SLT。

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