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Volume 46 Number 2, 2009
   Pages 175 — 184

Abstract - Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Part I-Background and methodology

Tobi Frymark, MA;1* Tracy Schooling, MA;1 Robert Mullen, MPH;1 Karen Wheeler-Hegland, PhD;2 John Ashford, PhD;3 Daniel McCabe, DMA;4 Nan Musson, MA;2 Carol Smith Hammond, PhD5-6

1American Speech-Language-Hearing Association, Rockville, MD; 2Malcom Randall Department of Veterans Affairs Medical Center (VAMC), Gainesville, FL; 3Tennessee State University/Vanderbilt University, Nashville, TN; 4Davenport and Taylor Memorial Hospital, Bath, NY; 5Durham VAMC, Durham, NC; 6Duke University, Durham, NC

Abstract — Evidence-based systematic reviews (EBSRs), in conjunction with clinical expertise and client values, are invaluable tools for speech-language pathologists and audiologists. This article provides an overview of the levels-of-evidence scheme used by the American Speech-Language-Hearing Association (ASHA) to conduct systematic reviews. The goal of ASHA reviews is to provide a tool to help clinicians determine the best treatment course for their clients. We present a collaborative project between ASHA's National Center for Evidence-based Practice in Communication Disorders and the Department of Veterans Affairs (VA) that examined seven behavioral swallowing treatments for disordered and nondisordered populations. The methodology used in a series of reviews conducted by ASHA and the VA will be discussed, including the development of clinical questions, search parameters, inclusion/exclusion criteria, and literature search results. Findings from the series of reviews as well as the practical applications of EBSRs will be reported in subsequent articles in this series.

Key words: critical appraisal, dysphagia, evidence-based practice, evidence-based systematic reviews, levels of evidence, methods, rehabilitation, speech-language pathology, swallowing maneuvers, swallowing postures, treatment.


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