Dear John:
About a year ago we produced a technology assessment titled "Diagnosis and
Treatment of Swallowing Disorders (Dysphagia) in Acute-Care Stroke Patients"
for the U.S. Agency for Healthcare Research and Quality (AHRQ, formerly
AHCPR), Publication No. 99-E024. You can obtain a copy by contacting AHRQ,
U.S. Department of Health and Human Services, 2101 East Jefferson Street,
Rockville, Maryland 20852; http://www.AHRQ.gov.
The gist of the assessment is that there have been no RCTs for dysphagia
diagnosis; however, a few historically controlled studies indicate that by
doing systematic dysphagia assessment of acute stroke patients, the
aspiration pneumonia rate can be dramatically reduced. Also, there was one
RCT that showed that a mechanically altered diet (soft food and thickened or
frozen liquids) resulted in substantially fewer cases of aspiration
pneumonia than pureed food.
I hope this is helpful. Good luck with your project.
David L. Doggett, Ph.D.
Senior Medical Research Analyst
Technology Assessment Group
ECRI, a non-profit health services research organization
5200 Butler Pike
Plymouth Meeting, PA 19462-1298, USA
Phone: +1 (610) 825-6000 ext.5509
Fax: +1(610) 834-1275
E-mail: [log in to unmask]
> -----Original Message-----
> From: [log in to unmask]
> [SMTP:[log in to unmask]]
> Sent: Friday, June 02, 2000 11:01 AM
> To: [log in to unmask]
> Subject: evidence-based patient pathway for stroke
>
> Dear all,
>
> I want to produce an 'evidence-based patient pathway' for management of
> stroke (from management of acute stroke through to rehabilitation,
> secondary prevention etc.). this can then be used as an evaluation tool to
> assess whether current practice in my district is evidence-based.
>
> I think I have identified all the relevant sources of evidence (including
> the RCP guidelines, SIGN guidelines, Cochrane reviews, Canadian
> guidelines, AHA guidelines etc.) and I know that in England the
> forthcoming National Service Framework for older people will cover stroke.
>
> Does anyone know of any similar work regarding development of an
> evidence-based patient pathway model (whether in the area of stroke care
> or otherwise) that can be used to assess current practice? Please email me
> if you can help.
>
> Kind regards,
> Dr John Powell
>
> Specialist Registrar in Public Health Medicine
> Buckinghamshire Health Authority
> [log in to unmask]
> +44 (0)1296 310143
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