Clinical Services

ePoster Presentation

(EP-109) Development of the e-HiT for Patients with Dysphagia and Comparison with a Traditional Case-history Form

Monday, April 24
6:00 PM - 6:15 PM
Location: Experience Zone - ePosters

Objectives
Case history completion is an important part of dysphagia (swallowing disorders) evaluations. For dysphagia tele-evaluation, there is a need for developing electronic case-history forms that can be completed remotely and are comparable to traditional case-history forms. We aim to:
1. Describe the development of an electronic case-history tool/form (e-HiT) for outpatient dysphagia clinics
2. Compare the e-HiT with its paper-based version
3. Discuss the clinical implications


Methods
A randomized, controlled two-period crossover design was used. This study was conducted between 08/15-05/16 at a University laboratory. Forty adults (26F,Mage=40) participated.

A case-history form for adults with dysphagia was developed and identical paper and electronic versions were created. The e-HiT was created on a HIPAA-aligned website. Participants were randomly assigned to Group A or B.

Visit 1: Information was collected on demographics, technology-related activities, and cognition via cognitive screening (independent variables). Then, Group A completed the e-HiT and Group B completed the paper-based version.

Visit 2: Group A completed the paper-based form and Group B completed the e-HiT.

There was a 7-day washout period between visits to avoid a carryover effect. A satisfaction survey was completed after each visit. The forms were compared on 4 outcome variables: completion time, completeness, independence, and patient perceptions/satisfaction. Paired-samples t-tests were conducted and a general linear model was fit to compare outcome variables.

Results
Completion time: Participants spent an average of 15.37 minutes (SD=672.3 seconds) and an average of 15.12 minutes (SD=468.31 seconds) to complete the e-HiT and paper-based forms, respectively. This was not statistically significant [t(39)=0.331,p=.742].

Completeness: Participants answered an average of 68/70 (SD=1.33) questions and an average of 69/70 questions (SD=1.8) on the e-HiT and paper-based forms, respectively, which was not significantly different [t(39)=-.703,p=.486].

Independence: Participants asked an average of 1.2 clarifying questions (SD=1.8) and an average of 1.3 questions (SD=1.5) while completing the e-HiT and paper-based forms, respectively [t(39)=-.337,p=.738].

Patient perceptions/satisfaction: The mean satisfaction score was 20.17 (SD=4.63) for the e-HiT and 22.15 (SD=5.51) for the paper-based form, which was statistically significant [t(39)=-3.08,p=.004].

Our general linear model significantly predicted completion time, F(12, 2)=7.15,p < 0.0001. Post hoc analysis revealed that age showed a statistically significant association (p=0.0063). As age increased, completion time also increased. Cognition level was not significant (p=0.4526).


Conclusion
Completing the e-HiT is as time efficient as its paper-based version, and both forms elicit the same amount of information independently. Furthermore, the e-HiT yielded significantly higher satisfaction, which is important for the adoption of this tool. Importantly, both patients with normal cognition and mild cognitive impairments were able to successfully complete the forms.

This is the first study establishing the effectiveness of an electronic dysphagia case history form (e-HiT) as compared to a paper-based version for outpatients with dysphagia, providing evidence that the first step of a clinical swallowing assessment (case history completion) can be effectively completed via telehealth. Future work should examine the perceptions/satisfactions of clinicians with the e-HiT, as well as the effectiveness and reliability of the next steps in the clinical swallowing assessment (including the clinical interview, cranial nerve assessment, and swallow trials) via telehealth.

Cagla Kantarcigil

Doctoral Student
Purdue University

Cagla Kantarcigil, MS, SLP is a doctoral student in the Dept. of Speech, Language, & Hearing Sciences at Purdue University. She is also a research assistant in the Imaging, Evaluation, & Treatment of Swallowing (I-EaT) Research Laboratory. Her research interests include investigating the effectiveness of telehealth in the management of swallowing disorders (dysphagia).

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Georgia Malandraki

Assistant Professor
Department of Speech, Language, and Hearing Sciences, Purdue University

Georgia A. Malandraki, PhD, CCC‐SLP, BCS‐S is an Assistant Professor of Speech, Language, and Hearing Sciences at Purdue University and a Board Certified Specialist in Swallowing Disorders (Dysphagia). Her research focuses on investigating developmental and treatment neuroplasticity, and developing rehabilitative and telehealth interventions for dysphagia.

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(EP-109) Development of the e-HiT for Patients with Dysphagia and Comparison with a Traditional Case-history Form



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