BACKGROUND: Texture modified diets (TMDs) are among the most widely used compensatory measures for managing dysphagia. TMDs are associated with significant risks involving nutrition, hydration, and quality of life. Speech-language pathologists (SLPs) are trained to evaluate and treat people with dysphagia and to assess client-specific appropriateness of TMDs. However, patients are regularly placed on TMDs by nursing staff without formal training in dysphagia and without SLP consult (Gurevich et al., 2021). OBJECTIVE: This study explores the experience of SLPs in health care with respect to such nursing initiated TMDs with the goal of assessing the prevalence of this practice. METHOD: SLP students, clinical fellows, and practicing clinicians (N = 503) were surveyed regarding their exposure to the nursing initiated TMD practice. RESULTS: Overall, 78.9% of respondents have directly encountered the nursing initiated TMD practice, with an additional 10% having heard of it. The group most susceptible to this practice, the certified clinicians who work with dysphagia alongside nurses (n = 461), had a higher rate of directly encountering this practice (82.2%). Among these, the early career clinicians (n = 104) had an even higher direct encounter rate at 87.5%. CONCLUSIONS: Findings show that nursing initiated TMDs are pervasive in United States (U.S.) health care, and SLPs are shown to regularly face this issue in their work settings as soon as they enter the workforce. Given negative outcomes associated with TMDs, patient care would be best served if decisions to implement TMDs were made by personnel with training in dysphagia.
{"title":"Speech-language pathologists’ experience with nursing initiated texture modified diets in health care settings","authors":"Naomi Gurevich, Danielle R. Osmelak","doi":"10.3233/acs-240002","DOIUrl":"https://doi.org/10.3233/acs-240002","url":null,"abstract":"BACKGROUND: Texture modified diets (TMDs) are among the most widely used compensatory measures for managing dysphagia. TMDs are associated with significant risks involving nutrition, hydration, and quality of life. Speech-language pathologists (SLPs) are trained to evaluate and treat people with dysphagia and to assess client-specific appropriateness of TMDs. However, patients are regularly placed on TMDs by nursing staff without formal training in dysphagia and without SLP consult (Gurevich et al., 2021). OBJECTIVE: This study explores the experience of SLPs in health care with respect to such nursing initiated TMDs with the goal of assessing the prevalence of this practice. METHOD: SLP students, clinical fellows, and practicing clinicians (N = 503) were surveyed regarding their exposure to the nursing initiated TMD practice. RESULTS: Overall, 78.9% of respondents have directly encountered the nursing initiated TMD practice, with an additional 10% having heard of it. The group most susceptible to this practice, the certified clinicians who work with dysphagia alongside nurses (n = 461), had a higher rate of directly encountering this practice (82.2%). Among these, the early career clinicians (n = 104) had an even higher direct encounter rate at 87.5%. CONCLUSIONS: Findings show that nursing initiated TMDs are pervasive in United States (U.S.) health care, and SLPs are shown to regularly face this issue in their work settings as soon as they enter the workforce. Given negative outcomes associated with TMDs, patient care would be best served if decisions to implement TMDs were made by personnel with training in dysphagia.","PeriodicalId":93726,"journal":{"name":"Advances in communication and swallowing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141270462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Cough and swallowing share common neuroanatomic pathways, leading to an overlap between their mechanisms. Despite the widely recognised role of cough as an airway defence mechanism, empirical evidence supporting its effectiveness for airway clearance is lacking. OBJECTIVE: This review summarises and appraises available evidence regarding the effectiveness of cough in response to airway penetration and/or aspiration during videofluoroscopic swallow study (VFSS) or flexible endoscopic evaluation of swallowing (FEES) in adults with oropharyngeal dysphagia (OD) of any aetiology. METHODS: The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were followed. Literature search was conducted in March 2023 and updated in March 2024 across six databases without publication status, language, or date restrictions. Two independent reviewers performed screening, with disagreements resolved through consensus and majority vote. The principal investigator conducted data extraction and quality appraisal using the Downs and Black checklist. RESULTS: Of 6,049 studies retrieved, 25 met the eligibility criteria. Due to heterogeneous reporting, a summary of participant demographics could not be compiled. Absence of a standardised method for measuring cough effectiveness meant meta-analysis was impossible. Nonetheless, an effective cough response to penetration/aspiration was noted for some participants within 17 studies, ineffective cough responses for some within 17 studies, while one study reported a partially effective cough response for participants. CONCLUSIONS: Robust evidence on cough effectiveness is lacking due to study heterogeneity and inconsistent reporting. Developing a standardised tool to assess cough effectiveness would ensure consistency and comparability across studies, improving clinical reporting of VFSS and FEES outcomes.
{"title":"Cough effectiveness during airway invasion in adults with oropharyngeal dysphagia: A systematic review of literature","authors":"Rubab Alhussainy, Chiara Bertolini, C. Kenny","doi":"10.3233/acs-230012","DOIUrl":"https://doi.org/10.3233/acs-230012","url":null,"abstract":"BACKGROUND: Cough and swallowing share common neuroanatomic pathways, leading to an overlap between their mechanisms. Despite the widely recognised role of cough as an airway defence mechanism, empirical evidence supporting its effectiveness for airway clearance is lacking. OBJECTIVE: This review summarises and appraises available evidence regarding the effectiveness of cough in response to airway penetration and/or aspiration during videofluoroscopic swallow study (VFSS) or flexible endoscopic evaluation of swallowing (FEES) in adults with oropharyngeal dysphagia (OD) of any aetiology. METHODS: The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were followed. Literature search was conducted in March 2023 and updated in March 2024 across six databases without publication status, language, or date restrictions. Two independent reviewers performed screening, with disagreements resolved through consensus and majority vote. The principal investigator conducted data extraction and quality appraisal using the Downs and Black checklist. RESULTS: Of 6,049 studies retrieved, 25 met the eligibility criteria. Due to heterogeneous reporting, a summary of participant demographics could not be compiled. Absence of a standardised method for measuring cough effectiveness meant meta-analysis was impossible. Nonetheless, an effective cough response to penetration/aspiration was noted for some participants within 17 studies, ineffective cough responses for some within 17 studies, while one study reported a partially effective cough response for participants. CONCLUSIONS: Robust evidence on cough effectiveness is lacking due to study heterogeneity and inconsistent reporting. Developing a standardised tool to assess cough effectiveness would ensure consistency and comparability across studies, improving clinical reporting of VFSS and FEES outcomes.","PeriodicalId":93726,"journal":{"name":"Advances in communication and swallowing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141271803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: From a medical perspective, autism is characterised by a dyad of impairments in social communication and interaction, and restricted, repetitive behaviours. However, the neurodiversity movement sees autism as a difference and not as a disability. Autistic individuals account for 1–2% of the population and many autistic children and their families access Speech & Language Therapy (SLT). In Ireland, SLT is provided across primary care, childrens’ disability network teams, as part of the progressing disability services for children and young people, and private providers. However, little is known about parents’ experiences accessing SLT services for autistic children. METHODS: This study aimed to investigate the parental experiences of SLT services for autistic children in the province of Munster, Ireland. Interpretative Phenomenological Analysis was used as a methodological framework. Semi-structured online interviews were carried out with six participants to identify their experiences of receiving SLT services for their autistic children. Data analysis followed a structured process, starting with in-depth explorations of individual datasets before cross-case analysis of the whole sample. FINDINGS: Participants expressed a variety of experiences and expectations of SLT provision, which centred on three thematic journeys: 1) Parenting an autistic child, 2) Experiencing and navigating SLT services for autistic children and 3) Evolving expectations of SLT service changes. CONCLUSIONS: Findings provide insight into parents’ individual and shared experiences of SLT services for autistic children, which may enrich service providers’ understanding of parents’ perceptions of SLT services. Future research should focus on exploring the experiences of autistic individuals and Speech and Language Therapists providing services for autistic children.2
{"title":"Speech and language therapy services for autistic children in Munster: An interpretative phenomenological analysis of parental experiences and expectations","authors":"David O'Shea, Dominika Lisiecka, Patrick McGarty","doi":"10.3233/acs-230010","DOIUrl":"https://doi.org/10.3233/acs-230010","url":null,"abstract":"BACKGROUND: From a medical perspective, autism is characterised by a dyad of impairments in social communication and interaction, and restricted, repetitive behaviours. However, the neurodiversity movement sees autism as a difference and not as a disability. Autistic individuals account for 1–2% of the population and many autistic children and their families access Speech & Language Therapy (SLT). In Ireland, SLT is provided across primary care, childrens’ disability network teams, as part of the progressing disability services for children and young people, and private providers. However, little is known about parents’ experiences accessing SLT services for autistic children. METHODS: This study aimed to investigate the parental experiences of SLT services for autistic children in the province of Munster, Ireland. Interpretative Phenomenological Analysis was used as a methodological framework. Semi-structured online interviews were carried out with six participants to identify their experiences of receiving SLT services for their autistic children. Data analysis followed a structured process, starting with in-depth explorations of individual datasets before cross-case analysis of the whole sample. FINDINGS: Participants expressed a variety of experiences and expectations of SLT provision, which centred on three thematic journeys: 1) Parenting an autistic child, 2) Experiencing and navigating SLT services for autistic children and 3) Evolving expectations of SLT service changes. CONCLUSIONS: Findings provide insight into parents’ individual and shared experiences of SLT services for autistic children, which may enrich service providers’ understanding of parents’ perceptions of SLT services. Future research should focus on exploring the experiences of autistic individuals and Speech and Language Therapists providing services for autistic children.2","PeriodicalId":93726,"journal":{"name":"Advances in communication and swallowing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140694937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: People with Aphasia (PwA) experience detrimental consequences post-stroke which can result in limited opportunities for social engagement and poor psychosocial ramifications. Peer support can improve psychosocial outcomes. Unfortunately, Covid-19 related social restrictions resulted in the closure of social outlets for PwA, further exacerbating social isolation. Some social networks transitioned online during this period. One such network was the Aphasia Café, a social group for PwA, supported by Speech and Language Therapy students (SLTS). OBJECTIVE: This study aimed to investigate the experiences, knowledge, attitudes, and beliefs about the Aphasia Café (in-person and online), within the context of pandemic-related social restrictions, from the perspectives of PwA and the SLTS who support them. METHODS: 16 SLTS participated in one of five focus groups. Six PwA were individually interviewed. Semi-structured questionnaires facilitated inductive and deductive data collection which were analysed using Framework Analysis. RESULTS: Observed themes related to the in-person and online Aphasia Café will be reported in this paper. Overarching themes observed from both SLTS and PwA include: ‘Socialising changes during Covid-19 pandemic’, ‘Awareness and Purpose of the Aphasia Café’, ‘Perceptions of an Online and In-Person Aphasia Café” (subthemes –accessibility, technology, time/timing, non-verbal communication, and social environment), and ‘Optimal Aphasia Café’ (PwA only). CONCLUSIONS: This study provides a unique perspective on the delivery of a supported informal conversation group from both PwA and the SLTS who facilitate it. Both online and in-person social spaces were considered to enhance the quality of life for PwA and give valuable experience for SLTS.
{"title":"“You’ll find most people who got involved with the Café couldn’t do without it now” – Socialising in an online versus in-person Aphasia Café","authors":"Shauna Bell, Andrea Horgan, Helen Kelly","doi":"10.3233/acs-230006","DOIUrl":"https://doi.org/10.3233/acs-230006","url":null,"abstract":"BACKGROUND: People with Aphasia (PwA) experience detrimental consequences post-stroke which can result in limited opportunities for social engagement and poor psychosocial ramifications. Peer support can improve psychosocial outcomes. Unfortunately, Covid-19 related social restrictions resulted in the closure of social outlets for PwA, further exacerbating social isolation. Some social networks transitioned online during this period. One such network was the Aphasia Café, a social group for PwA, supported by Speech and Language Therapy students (SLTS). OBJECTIVE: This study aimed to investigate the experiences, knowledge, attitudes, and beliefs about the Aphasia Café (in-person and online), within the context of pandemic-related social restrictions, from the perspectives of PwA and the SLTS who support them. METHODS: 16 SLTS participated in one of five focus groups. Six PwA were individually interviewed. Semi-structured questionnaires facilitated inductive and deductive data collection which were analysed using Framework Analysis. RESULTS: Observed themes related to the in-person and online Aphasia Café will be reported in this paper. Overarching themes observed from both SLTS and PwA include: ‘Socialising changes during Covid-19 pandemic’, ‘Awareness and Purpose of the Aphasia Café’, ‘Perceptions of an Online and In-Person Aphasia Café” (subthemes –accessibility, technology, time/timing, non-verbal communication, and social environment), and ‘Optimal Aphasia Café’ (PwA only). CONCLUSIONS: This study provides a unique perspective on the delivery of a supported informal conversation group from both PwA and the SLTS who facilitate it. Both online and in-person social spaces were considered to enhance the quality of life for PwA and give valuable experience for SLTS.","PeriodicalId":93726,"journal":{"name":"Advances in communication and swallowing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140386735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Long-COVID occurs in individuals with a history of probable or confirmed SARS CoV-2 infection. Long-COVID can affect individuals who experience both mild and severe acute COVID-19 and can involve and affect multiple body systems. Research thus far acknowledges swallowing and communication difficulties as a characteristic of Long-COVID, however, this research lacks detail and does not address the psychosocial impact of these problems. OBJECTIVES: To establish an understanding of the presence, severity, and trajectory of swallowing and communication difficulties as a symptom of Long-COVID among adults. To investigate the psychosocial impact of these characteristics and explore supports and barriers to recovery. METHODS: The objectives were addressed by utilizing a qualitative research design. Semi-structured interviews were carried out with participants using online Zoom sessions. The interviews were recorded and transcribed and reflexive thematic analysis was used to analyse the data. RESULTS: Seven participants from Ireland, Scotland and Australia were interviewed. Four main themes were identified including dysphagia-related issues, communication-related issues, psychosocial impact of dysphagia and communication disorders, and accessing Long-COVID related healthcare for dysphagia and communication disorders. The presentation of swallowing and communication problems was diverse and had significant psychosocial and mental health consequences. Furthermore, access to healthcare services to effectively treat these issues was challenging. CONCLUSIONS: The lack of recognition of swallowing and communication as a symptom of Long-COVID and its adverse effects is a pertinent issue which warrants further research and updated guidelines for individuals living with Long-COVID and healthcare professionals alike.
{"title":"Exploring the lived experiences and perspectives of individuals with communication and swallowing difficulties associated with Long-COVID","authors":"Ó. Gilheaney, Naomi Rogers, K. McTiernan","doi":"10.3233/acs-230007","DOIUrl":"https://doi.org/10.3233/acs-230007","url":null,"abstract":"BACKGROUND: Long-COVID occurs in individuals with a history of probable or confirmed SARS CoV-2 infection. Long-COVID can affect individuals who experience both mild and severe acute COVID-19 and can involve and affect multiple body systems. Research thus far acknowledges swallowing and communication difficulties as a characteristic of Long-COVID, however, this research lacks detail and does not address the psychosocial impact of these problems. OBJECTIVES: To establish an understanding of the presence, severity, and trajectory of swallowing and communication difficulties as a symptom of Long-COVID among adults. To investigate the psychosocial impact of these characteristics and explore supports and barriers to recovery. METHODS: The objectives were addressed by utilizing a qualitative research design. Semi-structured interviews were carried out with participants using online Zoom sessions. The interviews were recorded and transcribed and reflexive thematic analysis was used to analyse the data. RESULTS: Seven participants from Ireland, Scotland and Australia were interviewed. Four main themes were identified including dysphagia-related issues, communication-related issues, psychosocial impact of dysphagia and communication disorders, and accessing Long-COVID related healthcare for dysphagia and communication disorders. The presentation of swallowing and communication problems was diverse and had significant psychosocial and mental health consequences. Furthermore, access to healthcare services to effectively treat these issues was challenging. CONCLUSIONS: The lack of recognition of swallowing and communication as a symptom of Long-COVID and its adverse effects is a pertinent issue which warrants further research and updated guidelines for individuals living with Long-COVID and healthcare professionals alike.","PeriodicalId":93726,"journal":{"name":"Advances in communication and swallowing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139807476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Long-COVID occurs in individuals with a history of probable or confirmed SARS CoV-2 infection. Long-COVID can affect individuals who experience both mild and severe acute COVID-19 and can involve and affect multiple body systems. Research thus far acknowledges swallowing and communication difficulties as a characteristic of Long-COVID, however, this research lacks detail and does not address the psychosocial impact of these problems. OBJECTIVES: To establish an understanding of the presence, severity, and trajectory of swallowing and communication difficulties as a symptom of Long-COVID among adults. To investigate the psychosocial impact of these characteristics and explore supports and barriers to recovery. METHODS: The objectives were addressed by utilizing a qualitative research design. Semi-structured interviews were carried out with participants using online Zoom sessions. The interviews were recorded and transcribed and reflexive thematic analysis was used to analyse the data. RESULTS: Seven participants from Ireland, Scotland and Australia were interviewed. Four main themes were identified including dysphagia-related issues, communication-related issues, psychosocial impact of dysphagia and communication disorders, and accessing Long-COVID related healthcare for dysphagia and communication disorders. The presentation of swallowing and communication problems was diverse and had significant psychosocial and mental health consequences. Furthermore, access to healthcare services to effectively treat these issues was challenging. CONCLUSIONS: The lack of recognition of swallowing and communication as a symptom of Long-COVID and its adverse effects is a pertinent issue which warrants further research and updated guidelines for individuals living with Long-COVID and healthcare professionals alike.
{"title":"Exploring the lived experiences and perspectives of individuals with communication and swallowing difficulties associated with Long-COVID","authors":"Ó. Gilheaney, Naomi Rogers, K. McTiernan","doi":"10.3233/acs-230007","DOIUrl":"https://doi.org/10.3233/acs-230007","url":null,"abstract":"BACKGROUND: Long-COVID occurs in individuals with a history of probable or confirmed SARS CoV-2 infection. Long-COVID can affect individuals who experience both mild and severe acute COVID-19 and can involve and affect multiple body systems. Research thus far acknowledges swallowing and communication difficulties as a characteristic of Long-COVID, however, this research lacks detail and does not address the psychosocial impact of these problems. OBJECTIVES: To establish an understanding of the presence, severity, and trajectory of swallowing and communication difficulties as a symptom of Long-COVID among adults. To investigate the psychosocial impact of these characteristics and explore supports and barriers to recovery. METHODS: The objectives were addressed by utilizing a qualitative research design. Semi-structured interviews were carried out with participants using online Zoom sessions. The interviews were recorded and transcribed and reflexive thematic analysis was used to analyse the data. RESULTS: Seven participants from Ireland, Scotland and Australia were interviewed. Four main themes were identified including dysphagia-related issues, communication-related issues, psychosocial impact of dysphagia and communication disorders, and accessing Long-COVID related healthcare for dysphagia and communication disorders. The presentation of swallowing and communication problems was diverse and had significant psychosocial and mental health consequences. Furthermore, access to healthcare services to effectively treat these issues was challenging. CONCLUSIONS: The lack of recognition of swallowing and communication as a symptom of Long-COVID and its adverse effects is a pertinent issue which warrants further research and updated guidelines for individuals living with Long-COVID and healthcare professionals alike.","PeriodicalId":93726,"journal":{"name":"Advances in communication and swallowing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139867733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Aphasia is an impairment of language as a result of brain damage which can affect individuals after a stroke. Recent research in aphasia has highlighted new technologies and techniques that fall under the umbrella of big data and artificial intelligence (AI). OBJECTIVES: This review aims to examine the extent, range and nature of available research on big data and AI relating to aphasia post stroke. METHODS: A mapping review is the most appropriate format for reviewing the evidence on a broad and emerging topic such as big data and AI in post-stroke aphasia. Following a systematic search of online databases and a two-stage screening process, data was extracted from the included studies. This analysis process included grouping the research into inductively created categories as the different areas within the research topic became apparent. RESULTS: Seventy-two studies were included in the review. The results showed an emergent body of research made up of meta-analyses and quasi-experimental studies falling into defined categories within big data and AI in post-stroke aphasia. The two largest categories were automation, including automated assessment and diagnosis as well as automatic speech recognition, and prediction and association, largely through symptom-lesion mapping and meta-analysis. CONCLUSIONS: The framework of categories within the research field of big data and AI in post-stroke aphasia suggest this broad topic has the potential to make an increasing contribution to aphasia research. Further research is needed to evaluate the specific areas within big data and AI in aphasia in terms of efficacy and accuracy within defined categories.
{"title":"Big data and artificial intelligence in post-stroke aphasia: A mapping review","authors":"Gordon Pottinger, Áine Kearns","doi":"10.3233/acs-230005","DOIUrl":"https://doi.org/10.3233/acs-230005","url":null,"abstract":"BACKGROUND: Aphasia is an impairment of language as a result of brain damage which can affect individuals after a stroke. Recent research in aphasia has highlighted new technologies and techniques that fall under the umbrella of big data and artificial intelligence (AI). OBJECTIVES: This review aims to examine the extent, range and nature of available research on big data and AI relating to aphasia post stroke. METHODS: A mapping review is the most appropriate format for reviewing the evidence on a broad and emerging topic such as big data and AI in post-stroke aphasia. Following a systematic search of online databases and a two-stage screening process, data was extracted from the included studies. This analysis process included grouping the research into inductively created categories as the different areas within the research topic became apparent. RESULTS: Seventy-two studies were included in the review. The results showed an emergent body of research made up of meta-analyses and quasi-experimental studies falling into defined categories within big data and AI in post-stroke aphasia. The two largest categories were automation, including automated assessment and diagnosis as well as automatic speech recognition, and prediction and association, largely through symptom-lesion mapping and meta-analysis. CONCLUSIONS: The framework of categories within the research field of big data and AI in post-stroke aphasia suggest this broad topic has the potential to make an increasing contribution to aphasia research. Further research is needed to evaluate the specific areas within big data and AI in aphasia in terms of efficacy and accuracy within defined categories.","PeriodicalId":93726,"journal":{"name":"Advances in communication and swallowing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139595781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Slinger, Paul Leong, Sally Spencer, R. Slinger, R. Govender
BACKGROUND: Inducible laryngeal obstruction (ILO) describes an inappropriate narrowing of the larynx during breathing in. ILO can lead to several respiratory symptoms and be misidentified and treated as asthma, with associated patient morbidity and healthcare cost. ILO is also known as vocal cord dysfunction, or paradoxical vocal fold movement. The current reference assessment tool for diagnosing ILO is a video-laryngoscopy. However, timely access to specialist diagnostic laryngoscopy services may be challenging, and laryngoscopy may be poorly tolerated. AIMS: The aim of this cross-sectional, two-stage feasibility study is to determine whether abnormal vocal fold movements associated with ILO can be adequately visualised using trans-laryngeal ultrasound (TLUS) namely, the ILOTUS study: (ILO assessment via trans- laryngeal ultrasound). The second aim is to compare TLUS with a reference standard diagnostic tool to ascertain whether it may serve as a less invasive screening tool to assess ILO. Participants’ opinions about the acceptability of TLUS will also be gathered and compared with responses to a validated symptom score questionnaire. METHODS: In stage one, healthy volunteers (n = 30) will undergo TLUS to assess whether the vocal folds can be visualised,and whether narrowing of the vocal folds can be seen when they mimic ILO. Stage 2 will be conducted with a patient population(n = 30) referred to a tertiary airways service for breathlessness assessment. Participants in stage 2 will undergo the reference standard laryngoscopy as well as simultaneous TLUS. The level of agreement between TLUS and laryngoscopy will be evaluated, as well as comparison of symptom scores. DISCUSSION: This study will help inform future studies of the utility of TLUS in the assessment of ILO. This will be valuable for understanding whether TLUS could be offered as a non-invasive option for patients in the assessment of ILO if they are not able to tolerate or access laryngoscopy diagnostic services. It is not intended that TLUS will replace the current reference standard of video-laryngoscopy but may have potential as an early screening tool if found to be non-inferior.
{"title":"Is trans-laryngeal ultrasound (TLUS) an accurate and acceptable tool in the assessment of inducible laryngeal obstruction? A protocol for the ILOTUS: A cross-sectional, two-stage feasibility study","authors":"C. Slinger, Paul Leong, Sally Spencer, R. Slinger, R. Govender","doi":"10.3233/acs-230003","DOIUrl":"https://doi.org/10.3233/acs-230003","url":null,"abstract":"BACKGROUND: Inducible laryngeal obstruction (ILO) describes an inappropriate narrowing of the larynx during breathing in. ILO can lead to several respiratory symptoms and be misidentified and treated as asthma, with associated patient morbidity and healthcare cost. ILO is also known as vocal cord dysfunction, or paradoxical vocal fold movement. The current reference assessment tool for diagnosing ILO is a video-laryngoscopy. However, timely access to specialist diagnostic laryngoscopy services may be challenging, and laryngoscopy may be poorly tolerated. AIMS: The aim of this cross-sectional, two-stage feasibility study is to determine whether abnormal vocal fold movements associated with ILO can be adequately visualised using trans-laryngeal ultrasound (TLUS) namely, the ILOTUS study: (ILO assessment via trans- laryngeal ultrasound). The second aim is to compare TLUS with a reference standard diagnostic tool to ascertain whether it may serve as a less invasive screening tool to assess ILO. Participants’ opinions about the acceptability of TLUS will also be gathered and compared with responses to a validated symptom score questionnaire. METHODS: In stage one, healthy volunteers (n = 30) will undergo TLUS to assess whether the vocal folds can be visualised,and whether narrowing of the vocal folds can be seen when they mimic ILO. Stage 2 will be conducted with a patient population(n = 30) referred to a tertiary airways service for breathlessness assessment. Participants in stage 2 will undergo the reference standard laryngoscopy as well as simultaneous TLUS. The level of agreement between TLUS and laryngoscopy will be evaluated, as well as comparison of symptom scores. DISCUSSION: This study will help inform future studies of the utility of TLUS in the assessment of ILO. This will be valuable for understanding whether TLUS could be offered as a non-invasive option for patients in the assessment of ILO if they are not able to tolerate or access laryngoscopy diagnostic services. It is not intended that TLUS will replace the current reference standard of video-laryngoscopy but may have potential as an early screening tool if found to be non-inferior.","PeriodicalId":93726,"journal":{"name":"Advances in communication and swallowing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139617969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katie E Chadd, S. Harding, J. Mortley, Pam Enderby
BACKGROUND: Research indicates that speech and language therapy for individuals with aphasia delivered via telehealth is acceptable and facilitates good outcomes. Although adoption of telehealth has increased following COVID-19, it has not been implemented broadly. Telehealth could assist services to meet the recommended intensity of therapy for individuals with aphasia. OBJECTIVE: The study aimed to investigate the barriers and facilitators to adopting telehealth for individuals with aphasia at two local NHS trusts; and to co-design a telehealth solution responding to these challenges. The feasibility of this solution was also investigated. A secondary objective is to highlight the value of real-world data (RWD) collection in evaluating clinical practice. METHODS: An experience-based co-design study was conducted, which developed and piloted a bespoke telehealth solution across service pathways at two NHS sites. Feasibility was evaluated qualitatively through interviews and quantitatively from RWD collected through the telehealth software. RESULTS: The telehealth solution incorporated outsourcing of the service to a specialist company, provision of hardware and software and regular support for individuals with aphasia and their carers. Take up was associated with a positive impact and the RWD revealed a substantial increase in the hours of therapy the individuals with aphasia received. CONCLUSION: Personalised telehealth solutions which respond to local and personal needs are feasible and an acceptable way to increase the intensity of speech and language therapy for some individuals with aphasia, bringing services more in line with evidence-based recommendations and optimising patient outcomes. Embedded RWD collection systems are valuable for evaluation.
{"title":"Improving efficiency through innovation in the ‘real-world’: Feasibility of a co-designed telehealth solution for individuals with aphasia","authors":"Katie E Chadd, S. Harding, J. Mortley, Pam Enderby","doi":"10.3233/acs-220018","DOIUrl":"https://doi.org/10.3233/acs-220018","url":null,"abstract":"BACKGROUND: Research indicates that speech and language therapy for individuals with aphasia delivered via telehealth is acceptable and facilitates good outcomes. Although adoption of telehealth has increased following COVID-19, it has not been implemented broadly. Telehealth could assist services to meet the recommended intensity of therapy for individuals with aphasia. OBJECTIVE: The study aimed to investigate the barriers and facilitators to adopting telehealth for individuals with aphasia at two local NHS trusts; and to co-design a telehealth solution responding to these challenges. The feasibility of this solution was also investigated. A secondary objective is to highlight the value of real-world data (RWD) collection in evaluating clinical practice. METHODS: An experience-based co-design study was conducted, which developed and piloted a bespoke telehealth solution across service pathways at two NHS sites. Feasibility was evaluated qualitatively through interviews and quantitatively from RWD collected through the telehealth software. RESULTS: The telehealth solution incorporated outsourcing of the service to a specialist company, provision of hardware and software and regular support for individuals with aphasia and their carers. Take up was associated with a positive impact and the RWD revealed a substantial increase in the hours of therapy the individuals with aphasia received. CONCLUSION: Personalised telehealth solutions which respond to local and personal needs are feasible and an acceptable way to increase the intensity of speech and language therapy for some individuals with aphasia, bringing services more in line with evidence-based recommendations and optimising patient outcomes. Embedded RWD collection systems are valuable for evaluation.","PeriodicalId":93726,"journal":{"name":"Advances in communication and swallowing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139151174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Introduction to Advances in Communication and Swallowing Volume 26, Issue 2","authors":"Julie Regan, Irene P. Walsh","doi":"10.3233/acs-239004","DOIUrl":"https://doi.org/10.3233/acs-239004","url":null,"abstract":"","PeriodicalId":93726,"journal":{"name":"Advances in communication and swallowing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138586542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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