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将超声技术转化为吞咽和喉功能评估的临床实践:一项言语病理学为主导的共识研究。

Translating Ultrasound into Clinical Practice for the Assessment of Swallowing and Laryngeal Function: A Speech and Language Pathology-Led Consensus Study.

机构信息

The National Hospital for Neurology and Neurosurgery, Therapy & Rehabilitation Services, 2nd Floor 8-11 Queen Square, London, WC1N 3BG, UK.

SLT Department, Imperial College Healthcare Trust, Charing Cross Hospital, London, UK.

出版信息

Dysphagia. 2022 Dec;37(6):1586-1598. doi: 10.1007/s00455-022-10413-9. Epub 2022 Feb 24.

Abstract

Ultrasound (US) has an emerging evidence base for the assessment of swallowing and laryngeal function. Accessibility and technological advances support the use of US as a clinical assessment tool; however, there is insufficient evidence to support its translation into clinical practice. This study aimed to establish consensus on the priorities for translation of US into clinical practice for the assessment of swallowing and laryngeal function. Nominal Group Technique (NGT) was used as a formal method of consensus development. Clinicians and academics, all members of an international US working group, were invited to participate in the study. Two NGT meetings were held, where participants silently generated and then shared ideas. Participants anonymously ranked items. Rankings were aggregated before participants re-ranked items in order of priority. Discussions regarding rankings were recorded and transcribed to inform analysis. Member-checking with participants informed the final analysis. Participants (n = 15) were speech and language pathologists, physiotherapists and sonographers representing six countries. Fifteen items were identified and prioritised 1-13 (including two equally ranked items). Reliability, validity and normative data emerged as key areas for research while development of training protocols and engagement with stakeholders were considered vital to progressing US into practice. Analysis revealed common themes that might be addressed together in research, in addition to the ranked priority. A measured approach to the translation of US into clinical practice will enable effective implementation of this tool. Priorities may evolve as clinical and professional contexts shift, but this study provides a framework to advance research and clinical practice in this field.

摘要

超声(US)在评估吞咽和喉功能方面具有越来越多的循证医学证据。其便捷性和技术进步支持将 US 用作临床评估工具;然而,目前还没有足够的证据支持将其转化为临床实践。本研究旨在就将 US 转化为吞咽和喉功能评估的临床实践的优先事项达成共识。名义群体技术(NGT)被用作共识发展的正式方法。邀请了来自国际 US 工作组的临床医生和学者作为参与者。进行了两次 NGT 会议,与会者在会议上默默地提出并分享想法。参与者匿名对项目进行排名。在参与者根据优先级重新对项目进行排名之前,先对排名进行汇总。记录有关排名的讨论并将其转录以供分析。与参与者的成员检查为最终分析提供了信息。参与者(n=15)为来自六个国家的言语和语言病理学家、物理治疗师和超声医师。确定了 15 个项目并对其进行了 1-13 级的优先级排序(包括两个同等排名的项目)。可靠性、有效性和规范数据成为研究的关键领域,而制定培训协议和与利益相关者合作被认为是将 US 推进实践的关键。分析揭示了一些共同的主题,这些主题可能会在研究中一起得到解决,除了排名的优先级。对将 US 转化为临床实践的方法进行评估,将能够有效地实施这一工具。随着临床和专业环境的变化,优先事项可能会发生变化,但本研究为该领域的研究和临床实践提供了一个框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e82c/9643193/8925ef35fb35/455_2022_10413_Fig1_HTML.jpg

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