PTSLPOtherCoDAS2023

Multi-professional screening instrument for risk of broncho-aspiration in a hospital environment for the elderly population: validity evidence based on response processes.

Paloma Alves Miquilussi, Rosane Sampaio Santos, Giselle Aparecida de Athayde Massi

PMID 38126426

WHAT IT FOUND

Experienced hospital professionals applying a broncho-aspiration screening checklist to elderly patients rated items relevant and agreed strongly, but non-verbal signs of doubt appeared on every item.

Key findings

01The judges rated the items as relevant, with Content Validity Index values from 0.93 to 1.0, and agreement between evaluators was high, with Intraclass Correlation Coefficient values from 0.88 to 0.97.

02At least one non-verbal gesture suggesting doubt appeared for every item, and hesitation was most frequent for items 3 and 8.

03The judges' feedback led to a revised second version of the instrument for elderly patients, with a written instruction guide.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs

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What it does not show

The study tested how professionals understood and agreed with the items, not whether the instrument accurately identifies broncho-aspiration. It included only 15 experienced hospital professionals and 45 elderly inpatients from one reference hospital, and it did not test less experienced teams or other settings. Patients who were dependent on mechanical ventilation or had unstable oxygen saturation, heart rate or respiratory rate were excluded, so the instrument was not tested in those patients. The paper reports changes and a second version, but it does not report testing that second version.

The easy way to misread this

Do not conclude that the revised IMRRBAH accurately screens broncho-aspiration risk. The study tested item understanding and agreement among the professionals, not comparison with a swallowing or broncho-aspiration reference standard. The second version was produced but not tested.

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