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在康复治疗中验证耶鲁吞咽协议:一项前瞻性、双盲、多评估者研究。

Validation of the Yale Swallow Protocol in Post-Acute Care: A Prospective, Double-Blind, Multirater Study.

机构信息

SA Swallowing Services, Nashville, TN.

College of Health Sciences, University of Kentucky, Lexington.

出版信息

Am J Speech Lang Pathol. 2020 Nov 12;29(4):1937-1943. doi: 10.1044/2020_AJSLP-19-00147. Epub 2020 Jul 27.

Abstract

Purpose A systematic approach to the diagnosis and treatment of swallowing disorders relies heavily on valid and reliable screening protocols that provide clinicians with clear and objective information. The Yale Swallow Protocol (YSP) has been shown to be a useful, valid, and reliable screening tool for aspiration risk in the acute care setting. However, the YSP was not validated for use in post-acute care. This study evaluated the clinical utility of the YSP in the post-acute care setting. Method This prospective, double-blind, multirater study included a referred sample of 240 individuals, with varying medical diagnoses, who completed the YSP and an endoscopic evaluation of swallowing. Results Sensitivity for the YSP was 95.4%, specificity was 66.9%, positive predictive value was 77.6%, and negative predictive value was 92.4%. Conclusions The data from this prospective study appear to support the use of the YSP in post-acute care due to the ability to use the protocol on virtually all patients-regardless of diagnosis-and its high sensitivity and negative predictive value.

摘要

目的

系统的吞咽障碍诊断和治疗方法在很大程度上依赖于有效且可靠的筛选方案,这些方案为临床医生提供清晰和客观的信息。耶鲁吞咽协议(YSP)已被证明是一种在急性护理环境中用于评估吸入风险的有用、有效和可靠的筛选工具。然而,YSP 并未经过验证可用于康复后护理。本研究评估了 YSP 在康复后护理环境中的临床效用。方法:本前瞻性、双盲、多评估者研究纳入了 240 名具有不同医学诊断的患者,他们完成了 YSP 和吞咽内镜评估。结果:YSP 的灵敏度为 95.4%,特异性为 66.9%,阳性预测值为 77.6%,阴性预测值为 92.4%。结论:这项前瞻性研究的数据似乎支持在康复后护理中使用 YSP,因为该方案几乎可以用于所有患者(无论诊断如何),并且具有较高的灵敏度和阴性预测值。

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