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Assessing adherence to the evidence base in the management of poststroke dysphagia

Lookup NU author(s): Professor Lindsay Pennington, Hazel Roddam


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Objective: To evaluate the reliability and responsiveness to change of an audit tool to assess adherence to evidence of effectiveness in the speech and language therapy (SLT) management of poststroke dysphagia. Design: The tool was used to review SLT practice as part of a randomized study of different education strategies. Medical records were audited before and after delivery of the trial intervention. Setting: Seventeen SLT departments in the north-west of England participated in the study. Subjects: The assessment tool was used to assess the medical records of 753 patients before and 717 patients after delivery of the trial intervention across the 17 departments. A target of 10 records per department per month was sought, using systematic sampling with a random start. Analysis: Inter- and intra-rater reliability were explored, together with the tool's internal consistency and responsiveness to change. Results: The assessment tool had high face validity, although internal consistency was low (ra = 0.37). Composite scores on the tool were however responsive to differences between SLT departments. Both inter- and intra-rater reliability ranged from 'substantial' to 'near perfect' across all items. Conclusions: The audit tool has high face validity and measurement reliability. The use of a composite adherence score should, however, proceed with caution as internal consistency is low. © 2006 Edward Arnold (Publishers) Ltd.

Publication metadata

Author(s): Burton C, Pennington L, Roddam H, Russell I, Russell D, Krawczyk K, Smith HA

Publication type: Review

Publication status: Published

Journal: Clinical Rehabilitation

Year: 2006

Volume: 20

Issue: 1

Pages: 46-51

Print publication date: 01/01/2006

ISSN (print): 0269-2155

ISSN (electronic): 1477-0873


DOI: 10.1191/0269215506cr903oa

PubMed id: 16502749