Dysphagia Management and Research in an Acute-Care Military Treatment Facility: The Role of Applied Informatics.
Purpose: This report describes the development and preliminary analysis of a database for traumatically injured military service members with dysphagia.Methods: A multidimensional database was developed to capture clinical variables related to swallowing. Data were derived from clinical records and...
| Publicado en: | Military Medicine Vol. 181; pp. 138 - 145 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Oxford University Press / USA
May2016 Supplement
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=115356553&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 115356553 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00264075 4DV jtl: Military Medicine issn: 00264075 maglogo: N pubinfo: dt: May2016 Supplement vid: 181 pid: 622 pub: Oxford University Press / USA artinfo: ui: 115356553 115356553 NLM27168564 115356553 10.7205/MILMED-D-15-00170 NLM27168564 115356553 ppf: 138 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Dysphagia Management and Research in an Acute-Care Military Treatment Facility: The Role of Applied Informatics. aug: au: Solomon, Nancy Pearl Dietsch, Angela M. Dietrich-Burns, Katie E. Styrmisdottir, Edda L. Armao, Christopher S. affil: National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, 4954 North Palmer Road, Building 19, Bethesda, MD 20889. sug: subj: Medical Informatics Methods Primary Health Care Methods Deglutition Disorders Middle Age Medical Informatics Female Diet Therapy Methods Male Adolescence Probability Medical Informatics Standards Diet Therapy Statistics and Numerical Data Glasgow Coma Scale Trends Hospitals, Military Statistics and Numerical Data Retrospective Design Military Personnel Statistics and Numerical Data Adult Glasgow Coma Scale Scales Human Middle Aged: 45-64 years Adolescent: 13-18 years Adult: 19-44 years Female Male ab: Purpose: This report describes the development and preliminary analysis of a database for traumatically injured military service members with dysphagia.Methods: A multidimensional database was developed to capture clinical variables related to swallowing. Data were derived from clinical records and instrumental swallow studies, and ranged from demographics, injury characteristics, swallowing biomechanics, medications, and standardized tools (e.g., Glasgow Coma Scale, Penetration-Aspiration Scale). Bayesian Belief Network modeling was used to analyze the data at intermediate points, guide data collection, and predict outcomes. Predictive models were validated with independent data via receiver operating characteristic curves.Results: The first iteration of the model (n = 48) revealed variables that could be collapsed for the second model (n = 96). The ability to predict recovery from dysphagia improved from the second to third models (area under the curve = 0.68 to 0.86). The third model, based on 161 cases, revealed "initial diet restrictions" as first-degree, and "Glasgow Coma Scale, intubation history, and diet change" as second-degree associates for diet restrictions at discharge.Conclusion: This project demonstrates the potential for bioinformatics to advance understanding of dysphagia. This database in concert with Bayesian Belief Network modeling makes it possible to explore predictive relationships between injuries and swallowing function, individual variability in recovery, and appropriate treatment options. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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