Department of Special Education and Communication Disorders
ORCID IDs
Dietsch 0000-0003-4554-5365
Document Type
Article
Date of this Version
2016
Citation
Military Medicine (2016) 181(5): 138
Abstract
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.
Included in
Special Education and Teaching Commons, Speech and Hearing Science Commons, Speech Pathology and Audiology Commons
Comments
United States government work