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Background: Cervical auscultation (CA) involves listening to swallowing and respiratory sounds and/or vibrations to detect oropharyngeal aspiration (OPA). CA has shown promising diagnostic test accuracy when used with the clinical swallowing examination and is gaining popularity in clinical practise. There has not been a review to date analysing the accuracy of CA in paediatric and adult populations with meta‐analyses. Objectives: To determine the accuracy of CA in detecting OPA in paediatric and adult populations, when compared to instrumental assessments. Search Methods: Databases searched included MEDLINE, PubMed, Embase, CINAHL, AustHealth, Cochrane and Web of Science. The search was restricted between 01 October 2012 and 01 October 2022. Selection Criteria: Inclusion criteria included (a) all clinical populations of all ages, (b) who have had an instrumental assessment and (c) CA. All study types were included. Data Collection and Analysis: Studies were reviewed independently by two authors. The methodological quality of the studies was analysed using the QUADAS‐2. Main Results: Ten studies met the inclusion criteria for this review and meta‐analyses. The pooled diagnostic performance of CA in detecting OPA was 0.91 for sensitivity and 0.79 for specificity. The area under the curve summary receiver operating curve (sROC) was estimated to be 0.86, thereby indicating good discrimination of OPA. Most studies scored high for risk of bias in at least one domain in the QUADAS‐2, likely attributed to a lack of high‐quality prospectively designed studies. Conclusions: There are promising diagnostic test accuracies for the use of CA in detection of OPA. Future research could include using CA in specific clinical populations and settings, and identifying standardised criteria for CA. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to the existing knowledge What are the potential or actual clinical implications of this work? Published best‐practice guidelines and standardized protocols for voice assessment recommend multidisciplinary evaluation utilizing a comprehensive range of clinical measures. Previous studies report variations in assessment practices when compared with these guidelines.To provide an up‐to‐date evaluation of current global multidisciplinary practice patterns and the opinions of otolaryngologist, ear, nose and throat (ENT) and speech–language pathology (SLP) clinicians on initial assessment and differential diagnosis of adults with voice disorders (VDs).ENTs and SLPs worldwide who had worked with VDs within the last 10 years completed an anonymous online survey. Themes explored demographic information about the clinical practice, information about diagnostic assessment pathways, clinical assessments routinely used for initial voice evaluation and clinician perceived value of clinical assessments important for diagnosis.Patterns in the clinical practice of 88 SLPs and 21 ENTs from 18 countries with 1 to more than 25 years’ experience were analysed. Clinicians provided services across a range of locations, and a range of assessment pathways was available for initial evaluation. Case history, laryngoscopy and auditory–perceptual measures were the most frequently selected assessments. Most clinicians favoured formal assessment measures for auditory–perceptual evaluation. Clinicians placed equal weighting on ENT and SLP assessment to aid diagnosis for muscle tension VDs and functional neurological voice disorders (FVDs).Practice patterns for initial diagnostic voice assessment are largely consistent with the currently published guidelines. Decisions for the selection of assessment tools vary according to VD classification, and assessment decisions appear to be guided by case history. Clinicians are not always following established protocols for obtaining reliable standardized measures. Further research is needed to understand the barriers to adhering to standardized protocols and to develop evidence for the use of case history in the process of VD diagnosis. Best‐practice guidelines recommend a multidisciplinary and multidimensional assessment of adults with vocal symptoms. Prior uni‐disciplinary survey studies have reported a divergence in clinical practice with the recommended guidelines. No previous studies have examined otolaryngologists and SLPs concurrently to investigate the multidisciplinary approach clinicians’ use in a diagnostic voice assessment. This study highlights new insights into multidisciplinary voice evaluation practice patterns with an emphasis on diagnostic assessment from a global perspective. The findings build on prior research exploring clinical assessment pathways, service utilization and clinicians’ preferences when selecting clinical tools to inform a differential diagnosis. This paper provides insights to inform future service and resource planning to ensure the delivery of evidenced‐based diagnostic assessment pathways. This study also makes recommendations for areas of future research to understand barriers to clinicians following recommended best‐practice guidelines. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic and response changed clinical service delivery and practice for speech and language therapists (SLTs) in the United Kingdom. SLTs work with children with neurodisability regarding both difficulties with their communication and eating and drinking skills (oropharyngeal dysphagia). This survey aimed to specifically explore the impact of the COVID‐19 pandemic on SLT practice for school‐aged children with dysphagia. Methods: UK‐based SLTs working with school‐aged children with neurodisability and oropharyngeal dysphagia were recruited to share their perceptions on the impact of COVID‐19 on practice. Four questions focusing on COVID‐19 impact were part of a larger online survey exploring SLT clinical practice regarding mealtime management of children with neurodisability and oropharyngeal dysphagia, which included demographic information, service delivery, assessment and intervention practices. COVID‐19 impact questions were a mixture of multiple choice and free text responses. The survey was disseminated using professional networks and social media, between 14 May and 30 July 2021. Data were analysed using descriptive statistics and qualitative content analysis. Results: One hundred and two participants answered at least one of the four COVID‐19 questions. Eighty‐two per cent of SLTs either agreed or strongly agreed that COVID‐19 impacted on service delivery to children and families. Negative impacts on service delivery included school absences/closures, home visiting restrictions, families declining input and/or having barriers to telehealth use and the impact of mask wearing on interactions. Positive impacts included increased telehealth access and skills, increased contact with families and focus on children's eating and drinking function within the home environment. Participants aimed to maintain the increased contact with families alongside a hybrid service delivery approach of in‐person and virtual appointments. Conclusions: This survey provides novel information capturing SLT practice change across two waves of COVID‐19 and return to in‐person practice for UK children with neurodisability. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the influence of children's autism characteristics, sensory profiles and feeding difficulties on caregiver‐reported impact at mealtimes. Background: Caregivers of children (5–12 years) with a diagnosis of Autism Spectrum Disorder completed an online survey examining (a) demographic characteristics, (b) children's autism characteristics (Social Communication Questionnaire), (c) sensory profiles (Sensory Profile 2–short form), (d) feeding difficulties (Behavioural Paediatrics Feeding Assessment Scale, BPFAS) and (c) caregiver‐reported impact of feeding difficulties (Feeding‐Swallowing Impact Survey, FS‐IS). Results: Seventy‐eight caregivers completed surveys for 80 children. Children with clinically significant feeding difficulties on the BPFAS (n = 55, 68.8%) had higher levels of caregiver‐reported impact on daily activities, worry and feeding difficulties compared to children without clinically significant feeding difficulties (FS‐IS; U = 257.000, z = −4.471, p < 0.01). Spearman's rank correlation showed a statistically significant, moderate correlation between BPFAS total frequency score and FS‐IS Daily activities score, rs (98) = 0.56, p < 0.01, indicating that as the frequency of feeding difficulties increased, the impact of these feeding difficulties on caregivers also increased. Using multiple regression, a model comprising of the three factors was statistically significant (F[1, 78] = 87.75, p < 0.001, adj. R2 = 0.52), with children's frequency of feeding difficulties the strongest predictor of caregiver‐reported impact with a moderate effect size (r = 0.49). Conclusion: Autistic children's feeding difficulties had a greater impact on caregivers than autism or sensory profiles, with the frequency of feeding difficulties and the caregiver impact of these feeding difficulties positively correlated. The findings demonstrate that efforts to understand and address feeding difficulties in autistic children must extend beyond the children to include their families. [ABSTRACT FROM AUTHOR]

Patient-led recording occurs when a patient records a clinical encounter with their smart device. Understanding patient-led recording is important in ensuring a safe and patient-centered response to this behavior. This exploratory study provides insight into the patient perspective of patient-led recordings. We conducted 20 semistructured interviews with hospital and health service patients. The interview data was analyzed using thematic analysis. We identified three themes relating to patient-led recordings, including patient engagement, psychosocial, and health service. Findings suggest that health services move beyond querying the permissibility of recording and consider how to maximize the benefits of recording while reducing the risk of harm. Patients and clinicians need to be made aware of the potential broader psychosocial benefits of recording a clinical encounter during hospital admission. These results point to an urgent need for health services to develop policies and resources that support clinicians to work within a culture of recording. [ABSTRACT FROM AUTHOR]