Stadardized Assesment of Swallowing Impairment

Medical University Of South Carolina, Charleston SC

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Abstract

DESCRIPTION (provided by applicant): The origin of the candidate's interest in this award mechanism stems from her career pathway that has included the integration of meaningful patient-oriented research into the clinical practice of evaluating and treating patients with swallowing disorders. The ultimate career goal of the candidate is to independently study and define functional swallowing impairment in adult patients with chronic pulmonary disease; however, there exists no validated or reliable measurement tool that permits the detection and quantification of swallowing impairment. A preliminary step toward the future pathway of independent swallowing research of patients with chronic pulmonary disease will require the development of a swallowing impairment measurement tool to be used during the modified barium swallowing evaluation. This tool (the MBSImP) will be clinically meaningful, practically implemented, reliably scored and sensitive to the presence of observed aspiration and to external indicators of health and quality of life. The structure of this award provides a vehicle to facilitate achievement of these short-term and long-term goals, and to the candidate's successful progression from clinical excellence and early stage clinical scientist to an independent clinical researcher. A complex reduction and aggregation strategy is proposed in the research plan that requires knowledge of applied multivariate statistical analyses, measurement theory and scale development, factor analysis and latent variable modeling. The candidate has included a mentor and external advisor to oversee a comprehensive curriculum in her Career Plan that includes didactic coursework and independent studies in the areas of statistical design, measurement, and factor analysis. Achievement of the candidate's stated career goals will require comprehensive understanding of the gross anatomy, physiology and pathophysiology of the upper aerodigestive tract in its entirety. Advanced competency as a clinical scientist in the area of swallowing and swallowing disorders will require understanding and application of overlapping swallowing physiology. While Dr. Martin-Harris demonstrates strong clinical proficiency in the clinical study of oropharyngeal swallowing dynamics and pulmonary function, she has insufficient knowledge of cervical, thoracic and distal esophageal structure and function. Patients with pulmonary disease and the prospective patients to be studied in the research plan often present with coexisting oropharyngeal and esophageal swallowing disorders. Therefore, the Candidate has included didactic coursework in advanced head, neck and chest anatomy, head and neck surgical rotations, and independent studies with her primary mentor, a world renowned clinician and researcher of esophageal swallowing disorders.