Guideline conform diagnostics for dysphagia : Arepresentative survey of speech therapists at certified stroke units in Germany

Abstract

Almost 260,000 people in Germany suffer from astroke each year. As aconsequence, for more than 60% this leads to dysphagia. In order to prevent secondary diseases, such as pneumonia, malnutrition and dehydration, adifferentiated diagnosis by amultiprofessional team in astroke unit is required. The guidelines in 2015 for diagnosing neurologic dysphagia by the German Society of Neurology recommend adetailed anamnesis, astandardized screening, aclinical swallowing examination and additional instrumental diagnostics. This study examined whether dysphagia is diagnosed by speech therapists at certified stroke units according to the recommended guidelines. An online questionnaire was compiled and sent to 1 speech therapist at each of the 195 certified stoke units and 112 participants responded to the questionnaire. The questionnaire consisted of questions about anamnesis, clinical swallowing diagnostics and the instrumental diagnostics. Of the speech therapists working on a stroke unit 57% participated in this study. The results show that 50% of the participants elaborated adetailed and differentiated anamnesis, 64% used astandardized screening (Daniels test) and 66% implemented aguideline conform swallowing test. As technical instruments, 35% of the respondents used video fluoroscopy and 71% of the respondents afiber endoscopy. The implementation of adetailed and differentiated anamnesis, standardized screening, and aclinical swallowing examination with testing of different food consistencies suggests ahigh quality of the dysphagia diagnostics at stroke units in Germany. The increasing availability of technical instruments, especially fiber endoscopy, substantiates this view.