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Article

A New Simple Screening Tool—4QT: Can It Identify Those with Swallowing Problems? A Pilot Study

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St Thomas’ Hospital, Lambeth Palace Road, London SE1 7EH, UK
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Royal Alexandra Hospital, Paisley, Renfrewshire PA2 9PJ, UK
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Northwick Park Hospital, Watford Road, Harrow HA1 3UJ, UK
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Guy’s Hospital, St Thomas’ Road, London SE1 9RS, UK
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Queen Elizabeth Hospital, Stadium Road, Woolwich SE18 4QH, UK
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Dept Sports Science, University of Greenwich, London SE9 2UG, UK
*
Author to whom correspondence should be addressed.
Geriatrics 2020, 5(1), 11; https://doi.org/10.3390/geriatrics5010011
Received: 3 January 2020 / Revised: 12 February 2020 / Accepted: 25 February 2020 / Published: 27 February 2020
(This article belongs to the Special Issue The Rehabilitation and Management of Dysphagia)
As people and the population age, the prevalence of swallowing problems (dysphagia) increases. The screening for dysphagia is considered good practice in stroke care, yet is not routinely undertaken in the management of frail older adults. A short swallow screen, the 4QT, was developed following a review of the literature. The screen has four questions relating to swallowing that can be asked by a member of the health care team. A convenience sample of 48 older frail patients on an acute frailty ward was recruited into a Quality Improvement project. Their swallow was screened using the EAT-10 and 4QT. A speech and language therapist assessed for the presence of dysphagia using a standardised assessment for dysphagia. The 4QT was as effective as the EAT-10 in identifying older frail adults with potential swallowing problems (Κ = 0.73). The 4QT has 100% sensitivity, 80.4% specificity and positive predictive value (PPV) 50%, negative predictive value (NPV) 100%. The 4QT is a highly sensitive but not specific swallow screen, only 50% of people reporting swallowing problems were confirmed to have a degree of dysphagia by the SLT. The 4QT is a simple screening tool that could be used by all staff, but requires further research/evaluation before it is widely accepted into clinical practice. View Full-Text
Keywords: swallow screen; dysphagia; 4QT; frail swallow screen; dysphagia; 4QT; frail
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MDPI and ACS Style

Tsang, K.; Lau, E.S.; Shazra, M.; Eyres, R.; Hansjee, D.; Smithard, D.G. A New Simple Screening Tool—4QT: Can It Identify Those with Swallowing Problems? A Pilot Study. Geriatrics 2020, 5, 11. https://doi.org/10.3390/geriatrics5010011

AMA Style

Tsang K, Lau ES, Shazra M, Eyres R, Hansjee D, Smithard DG. A New Simple Screening Tool—4QT: Can It Identify Those with Swallowing Problems? A Pilot Study. Geriatrics. 2020; 5(1):11. https://doi.org/10.3390/geriatrics5010011

Chicago/Turabian Style

Tsang, Karwai, Esther S. Lau, Mariyam Shazra, Ruth Eyres, Dharinee Hansjee, and David G. Smithard. 2020. "A New Simple Screening Tool—4QT: Can It Identify Those with Swallowing Problems? A Pilot Study" Geriatrics 5, no. 1: 11. https://doi.org/10.3390/geriatrics5010011

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