Diagnosis and Treatment of Swallowing Disorders (Dysphagia) in Acute-Care Stroke211 Patients. Evidence Report/Technology Assessment Number 8

摘要

The report was requested by the Health Care Financing Administration, which211u001esought an evidence-based assessment of methods for diagnosing and treating 211u001eswallowing disorders (dysphagia) in elderly individuals with neurologic diseases, 211u001eand specifically those methods associated with the services provided by speech-211u001elanguage pathologists. About 6,228,000 Americans over age 60 have dysphagia, and 211u001eabout 300,000 to 600,000 people are affected by dysphagia resulting from 211u001eneurologic disorders each year. This report addresses four questions: (1) How 211u001edoes diagnosis of dysphagia or aspiration affect treatment course sand patient 211u001eoutcomes; (2) What are the indications for diagnosing patients using a full 211u001ebedside exam (BSE), modified barium swallow, fiberoptic endoscopy, or other 211u001einstrumented exams; (3) Is one diagnostic technology more effective than any 211u001eother; and (4) When is noninvasive therapy appropriate, and when should feeding 211u001etubes be used in certain patient populations.