Clinical practice and research methods: best friends or worlds apart?
A couple months ago, we talked about reading research and how to investigate new interventions (big thank you again to Ed Bice for sharing his filtering tool—if you missed this, be sure to check it out at Life of Janie), and boy did this resonate with a lot of us! Some questions that popped up– how do I interpret reliability/validity/results in research papers? What is the difference between internal and external consistency?? What on earth is face validity? Whew!
If you are like me, it can get a little overwhelming to read these papers and you might even just give up and go to social media for some answers. But there are good reasons why we might want to be able to get better at interpreting research ourselves (including being able to collect valid data in our own clinical practices!), so here are some resources to find out more about the why and how:
This great article by Dr. Susan Brady and Dr. Kathleen Ruroede: “How to Conduct Dysphagia Research in the Work Setting: Practical Tips for the Clinician” is well-written and gives a an easy-to-understand perspective on key points of good research and what various terms mean.
These short educational videos from the Shirly Ryan Ability Lab in which they break down what to look for and why in outcome measurement tools in rehabilitation.*
This really nice post on Dysphagia Café, written by Rebecca Bowen, M.A. CCC-SLP and Mariel Solomon, MS, CCC-SLP where they discuss matching types of evidence to clinical questions.
And this excellent recent episode of Dr. Tim Stockdale’s Swallow the Gap Podcast featuring the dynamic duo of Dr. Giselle Carnaby, MPH, PhD, CCC-SLP, F-ASHA, Honors ASHA and Dr. Michael Crary, PhD, F-ASHA, Honors ASHA in which they share some behind-the-scenes work of research design as well as the importance of patient-centric research (and intervention)…as well as drop impactful truths from their years of experience in the field of dysphagia and research.
Finally, a terrific offering from STEP Community by Dr. Ianessa Humbert: Swallowing Masterclass Tier 1. This well-organized course will take you into a deeper dive on terminology, what makes good data collection, and even a look at why our brain wants to accept a meme over science (crazy but true!). You can receive 0.25 ASHA CEUs and it’s really affordable at $98.
Let me know what you think!
I would love to hear from you!
*The Rehabilitation Measures Database was initially funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), Administration for Community Living, United States Department of Health and Human Services through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (H133B090024). Current funding for the Rehabilitation Measures Database comes from the Shirley Ryan AbilityLab and NIDILRR through the Knowledge Translation Disability Rehabilitation Research Project on Promoting Patient-Centered Care through Use of Standardized Assessments (90DPKT0007), the Rehabilitation Research and Training Center on Employment for People with Physical Disabilities (90RTEM0001), and the Midwest Regional Spinal Cord Injury Model System (90SI5009).
Recent Posts:
A Critical Eye for the Clinician to Apply
If you are like me, you are really working hard to keep up in dysphagia. You listen to podcasts, you read the ASHA SIG 13 conversations, you attend webinars, you read the research, keep up with and implement all new interventions…Whoops! Let’s talk about that last...
Contribute to Swallowing and Dyphagia Research!
Use TIMS? Use MBSImP™©? Help shape the future of our field! I had been using our TIMS system to review and record MBS studies for at least a couple of years without much thought…do the study, review it frame by frame, taking measurements and making notes on screen...
As an SLP, Learning Never Stops
Continuous Improvement in MBSS. We need to know better AND do better. In my very first hospital job, I was provided with excellent training in MBS studies. I LOVED them, and I was constantly looking for ways to be the BEST at conducting, interpreting, and using them...
Radiation Safety
Radiation safety—how does the MBSS measure up? I had such a cool conversation about radiation the other day—I just had to share! I have been working with a great RPA (Radiology Practitioner Assistant) for a while now, and we grabbed lunch together and of course, the...
A New Year, A New Look at Healthcare Equity
Welcome to a New Year! New Year, New…Perspectives It is hard to believe that another year has flown by! Last year was a great year of learning for me…one my favorite topics that really came to prominence last year in dysphagia is the consideration of healthcare equity...
Filling in the gaps in your swallowing knowledge!
Last fall, I attended Rocky Mountain University’s “Hard to Swallow: A Catalyst for Change in Dysphagia Management” virtual conference, directed by Dr. Tim Stockdale, SLPD, CCC-SLP. A really and truly fantastic event, I talked about it for DAYS to my colleagues. So...
Person-Centered Caring
With the many demands placed upon practicing SLPs, it can become so easy to get bogged down with productivity, keeping up with professional development, and the very real burnout of it all. When this happens to me, I try hard to focus on why I went into this branch of...
Do You See What I See (On That MBSS)?
You asked for resources, I’ll give you resources! One question I have received quite a bit in the last year through these emails is some variation of, “Where can I find more swallow studies to look at so I get better at them?” So, this month, I thought I would share...
2-4-6-8 How Do We AD-VO-CATE?
As Demi Lovato says, “What’s wrong with being confident?!” Early in my career, I was told by my supervisor that I “didn’t need so many instrumental swallowing assessments”, and that I “should know most of what the MBSS will show before it even happens” and that...
A New Resource in Swallowing Education!
Go back to school from the convenience of home! I don’t know about you, but I just LOVE an easily accessible, high-quality, affordable educational resource. Knowing who to trust when it comes to professional development saves me so much time and mental energy…and when...
INDICATIONS AND USAGE | IMPORTANT SAFETY INFORMATION
VARIBAR® (barium sulfate)
IMPORTANT SAFETY INFORMATION:
For Oral Administration. This product should not be used in patients with known or suspected perforation of the GI tract, known obstruction of the GI tract, high risk of aspiration, or hypersensitivity to barium sulfate products. Rarely, severe allergic reactions of anaphylactoid nature have been reported following administration of barium sulfate contrast agents. Aspiration may occur during the modified barium swallow examination, monitor the patient for aspiration.
INDICATIONS AND USAGE | IMPORTANT SAFETY INFORMATION
VARIBAR® (barium sulfate)
INDICATIONS
VARIBAR® THIN HONEY (barium sulfate) oral suspension, VARIBAR® NECTAR (barium sulfate) oral suspension, and VARIBAR® THIN LIQUID (barium sulfate) oral suspension are radiographic contrast agents indicated for use in modified barium swallow examinations to evaluate the oral and pharyngeal function and morphology in adult and pediatric patients.
VARIBAR® HONEY (barium sulfate) oral suspension and VARIBAR® PUDDING (barium sulfate) oral paste are radiographic contrast agents indicated for use in modified barium swallow examinations to evaluate the oral and pharyngeal function and morphology in adult and pediatric patients 6 months of age and older.
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS
These products should not be used in patients with known or suspected perforation of the gastrointestinal (GI) tract; known obstruction of the GI tract; high risk of GI perforation such as those with a recent GI perforation, acute GI hemorrhage or ischemia, toxic megacolon, severe ileus, post GI surgery or biopsy, acute GI injury or burn, or recent radiotherapy to the pelvis; high risk of aspiration such as those with known or suspected tracheo-esophageal fistula or obtundation; known severe hypersensitivity to barium sulfate or any of the excipients of the product used.
WARNINGS AND PRECAUTIONS
Hypersensitivity Reactions
Barium sulfate preparations contain a number of excipients, including natural and artificial flavors, and may induce serious hypersensitivity reactions. The manifestations include hypotension, bronchospasm and other respiratory impairments, and dermal reactions including rashes, urticaria, and itching. A history of bronchial asthma, atopy, food allergies, or a previous reaction to a contrast agent may increase the risk for hypersensitivity reactions. Emergency equipment and trained personnel should be immediately available for treatment of a hypersensitivity reaction.
Intra-abdominal Barium Leakage
The use of VARIBAR PRODUCTS is contraindicated in patients at high risk of perforation of the GI tract. Administration of VARIBAR PRODUCTS may result in leakage of barium from the GI tract in the presence of conditions such as carcinomas, GI fistula, inflammatory bowel disease, gastric or duodenal ulcer, appendicitis, or diverticulitis, and in patients with a severe stenosis at any level of the GI tract, especially if it is distal to the stomach. The barium leakage has been associated with peritonitis and granuloma formation.
Delayed Gastrointestinal Transit and Obstruction
Orally administered barium sulfate may accumulate proximal to a constricting lesion of the colon, causing obstruction or impaction with development of baroliths (inspissated barium associated with feces) and may lead to abdominal pain, appendicitis, bowel obstruction, or rarely perforation. Patients with the following conditions are at higher risk for developing obstruction or baroliths: severe stenosis at any level of the GI tract, impaired GI motility, electrolyte imbalance, dehydration, on a low residue diet, taking medications that delay GI motility, constipation, pediatric patients with cystic fibrosis or Hirschsprung disease, and the elderly. To reduce the risk of delayed GI transit and obstruction, patients should maintain adequate hydration after the barium sulfate procedure. When administering VARIBAR PUDDING, consider the administration of laxatives.
Aspiration Pneumonitis
The use of VARIBAR PRODUCTS is contraindicated in patients with trachea-esophageal fistula. Oral administration of barium is associated with aspiration pneumonitis, especially in patients with a history of food aspiration or with compromised swallowing mechanism. Vomiting following oral administration of barium sulfate may lead to aspiration pneumonitis. In patients at risk for aspiration, begin the procedure with a small ingested volume of VARIBAR PRODUCTS. Monitor the patient closely for aspiration, discontinue administration of VARIBAR PRODUCTS if aspiration is suspected, and monitor for development of aspiration pneumonitis.
Systemic Embolization
Barium sulfate products may occasionally intravasate into the venous drainage of the GI tract and enter the circulation as a "barium embolus" leading to potentially fatal complications which include systemic and pulmonary embolism, disseminated intravascular coagulation, septicemia and prolonged severe hypotension. Although this complication is exceedingly uncommon after oral administration of a barium sulfate suspension, monitor patients for potential intravasation when administering barium sulfate.
ADVERSE REACTIONS
The most common adverse reactions are nausea, vomiting, diarrhea, and abdominal cramping. Serious adverse reactions and fatalities include aspiration pneumonitis, barium sulfate impaction, intestinal perforation with consequent peritonitis and granuloma formation, vasovagal and syncopal episodes.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please click here for full Prescribing Information for VARIBAR® THIN LIQUID (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® THIN HONEY (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® NECTAR (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® HONEY (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® PUDDING (barium sulfate) oral paste.
VARIBAR is manufactured by E-Z-EM Canada Inc., for E-Z-EM, Inc., a subsidiary of Bracco Diagnostics Inc., Princeton, NJ 08540.
VARIBAR is a registered trademark of E-Z-EM, Inc.
INDICATIONS AND USAGE | IMPORTANT SAFETY INFORMATION
VARIBAR® (barium sulfate)
IMPORTANT SAFETY INFORMATION:
For Oral Administration. This product should not be used in patients with known or suspected perforation of the GI tract, known obstruction of the GI tract, high risk of aspiration, or hypersensitivity to barium sulfate products. Rarely, severe allergic reactions of anaphylactoid nature have been reported following administration of barium sulfate contrast agents. Aspiration may occur during the modified barium swallow examination, monitor the patient for aspiration.
Talk Soon,
US-VARH-2500008 08/25