L6 Screening Flashcards
Define Symptom:
An observation felt or described by the patient
Define Sign:
An observation made by an examiner.
Define Complication:
Signs and symptoms that result due to treatments
If a patient says they have trouble chewing this is an example of a ________
symptom
Abnormalities seen on clinical or VF exams are an example of a ______
sign
_______ predicts the presence of a disease. It is defined by CASLPO as a process where a member applies certain measures that are designed to
identify patients who may have a disorder[s], for the sole purpose of determining the patient’s need for a speech language pathology assessment.
Screening
________ is an example of a screening test
Burke Screening Test
_________ predicts the presence or absence of a non-observable disease or determines the presence of an observable disease.
Clincial evaluation
________ is used to determine the presence of oral, pharyngeal and upper esophageal dysphagia.
Instrumental Evaluation
How does CASLPO define Screening:
a process where a member applies certain measures that are designed to identify patients who may have a disorder[s], for the sole purpose of determining the patient’s need for a speech language pathology assessment
T or F: Inadvertently noticing an issue with swallowing is the same as a screening
False
List 7 characteristics of a screening:
1) Informal
2) Administration by a team member
3) Non invasive
4) Non technical
5) Results quickly interpretable
6) Reliable
7) Accurate
What are the two questions answered by a screening?
1) High likelihood for dysphagia (including
aspiration) ?
2) Is patient candidate for further testing?
Who selects a dysphagia screening tool?
SLP
When selecting the screening tool the SLP asks themself:
- purpose
- target population
- who designed it and when
- validated
- sample size
- population validated for
- Sensitivity, Specificity and Likelihood Ratio scores and how does it compare to other screening tools
- reliability?
- country designed in?
- extent of training required and by whom?
- Positives and negatives of tool.
- Level of evidence of tool.. (1, 2, 3)
Describe the three levels of evidence:
Level 1 - at least one prospective, randomized controlled study has found the intervention to be effective.
Level 2 - one non-randomized cohort comparison, multicentre case-study series, or chronological series has found the intervention to be effective. Evidence may also be part of extraordinary results from randomized clinical trials.
Level 3 - Canadian professional association guidelines, standard practice in other jurisdictions, descriptive studies, reports of an expert committee, collective experience of a consensus panel, or expert
opinion have judged the intervention to be effective.”
What is the best level of evidence?
Level 1
On the Burke Dysphagia Screening test, if any one of which 7 features is present the result is a fail:
1) Bilateral hemispheric stroke
2) Brainstem stroke
3) History of Pneumonia during the acute stroke phase
4) Coughing associated with feeding or during a 3 oz water swallow test
5) failure to consume on half of meals
6) Prolonged time required for feeding
7) Non-oral feeding program in place
Describe the 50 ml test:
Abnormal if:
The patient drinks 50 ml in 5ml aliquots ie. 10 tsp
Abnormal if choking, coughing, altered voice and test was not discontinued
T or F: We give the patient 10 tbsp in the 50 ml Test
False - TSP not TBSP
Describe the 3 oz test:
Abnormal if:
The patient is given a cup with three oz of water and has to drink it without interruption. The patient must be seated upright and be alert enough to hold the cup and drink.
Abnormal if cough within one minute
T or F: The 50 ml test is a better test
True - equal sensitivity, better specificity and better likelihood ratio
_______ is the probability that the presence of dysphagia screening test is positive
sensitivity
______ is the probability that the absence of dysphagia screening test is negative.
specificity
