Ebru Umay1, Sibel Eyigor2, Esra Giray3, Evrim Karadag Saygi4, Bulent Karadag5, Nihal Durmus Kocaaslan6, Deniz Yuksel7, Arzu Meltem Demir8, Engin Tutar9, Canan Tikiz10, Eda Gurcay11, Zeliha Unlu10, Pelin Celik12, Ece Unlu Akyuz13, Guven Mengu14, Serkan Bengisu15, Sibel Alicura16, Necati Unver17, Nida Yekteusaklari4, Cuma Uz13, Merve Cikili Uytun18, Fatih Bagcier19, Elif Tarihci20, Mazlum Serdar Akaltun21, Iclal Ayranci Sucakli11, Damla Cankurtaran13, Zeynep Aykın22, Resa Aydın20, Fatma Nazli23. 1. Department of Physical Medicine and Rehabilitation Ankara, University of Health Sciences Turkey, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Istanbul, Turkey. ebruumay@gmail.com. 2. Department of Physical Medicine and Rehabilitation, Ege University, Izmir, Turkey. 3. Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospıtal, Istanbul, Turkey. 4. Department of Physical Medicine and Rehabilitation, Marmara University, Istanbul, Turkey. 5. Department of Pediatric Pulmonology, Marmara University, Istanbul, Turkey. 6. Department of Plastic, Reconstructive and Aesthetic Surgery, Marmara University, Istanbul, Turkey. 7. Department of Pediatric Neurology, University of Health Sciences, Ankara Dr Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey. 8. Department of Pediatric Gastroenterology, Ankara City Hospital, Ankara, Turkey. 9. Department of Pediatric Gastroenterology, Marmara University, Ankara, Turkey. 10. Department of Physical Medicine and Rehabilitation, Celal Bayar University, Manisa, Turkey. 11. University of Health Sciences Turkey, Gaziler Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey. 12. Department of Developmental Pediatric, Ankara City Hospital, Ankara, Turkey. 13. Department of Physical Medicine and Rehabilitation Ankara, University of Health Sciences Turkey, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Istanbul, Turkey. 14. Department of Western Languages and Literatures, Ankara Haci Bayram Veli University, English Language and Literature Division, Ankara, Turkey. 15. Department of Speech and Language Therapy, Uskudar University, Istanbul, Turkey. 16. Department of Otolaryngology, Head and Neck Surgery, University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. 17. Department of Otolaryngology, Head and Neck Surgery, Marmara University, Istanbul, Turkey. 18. Department of Child and Adolescent Psychiatry, Ankara University, Ankara, Turkey. 19. Department of Physical Medicine and Rehabilitation, Istanbul Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey. 20. Department of Physical Medicine and Rehabilitation, Istanbul University, Istanbul, Turkey. 21. Department of Physical Medicine and Rehabilitation, Gaziantep University, Gaziantep, Turkey. 22. Ministry of Health, Mamak Public Hospital, Ankara, Turkey. 23. Department of Physical Medicine and Rehabilitation, Kirikkale University, Kirikkale, Turkey.
Abstract
BACKGROUND: Currently, there is no comprehensive and multidisciplinary recommendation study covering all aspects of pediatric dysphagia (PD). This study aimed to generate PD management recommendations with methods that can be used in clinical practice to fill this gap in our country and in the world, from the perspective of experienced multidisciplinary experts. METHODS: This recommendation paper was generated by a multidisciplinary team, using the seven-step process and a three-round modified Delphi survey via e-mail. First, ten open-ended questions were created, and then detailed recommendations including management, diagnosis, treatment, and follow-up were created with the answers from these questions. Each recommendation item was voted on by the experts as overall consensus (strong recommendation), approaching consensus (weak recommendation) and divergent consensus (not recommended). RESULTS: In the 1st Delphi round, a questionnaire of 414 items was prepared based on the experts' responses to ten open-ended questions. In the 2nd Delphi round, 59.2% of these items were accepted as pre-recommendation. In the 3rd Delphi round, 62.6% of 246 items were accepted for inclusion in the proposals. The final version recommendations consisted of 154 items. CONCLUSIONS: This study includes comprehensive and detailed answers for every problem that could be posed in clinical practice for the management of PD, and recommendations are for all pediatric patients with both oropharyngeal and esophageal dysphagia.
BACKGROUND: Currently, there is no comprehensive and multidisciplinary recommendation study covering all aspects of pediatric dysphagia (PD). This study aimed to generate PD management recommendations with methods that can be used in clinical practice to fill this gap in our country and in the world, from the perspective of experienced multidisciplinary experts. METHODS: This recommendation paper was generated by a multidisciplinary team, using the seven-step process and a three-round modified Delphi survey via e-mail. First, ten open-ended questions were created, and then detailed recommendations including management, diagnosis, treatment, and follow-up were created with the answers from these questions. Each recommendation item was voted on by the experts as overall consensus (strong recommendation), approaching consensus (weak recommendation) and divergent consensus (not recommended). RESULTS: In the 1st Delphi round, a questionnaire of 414 items was prepared based on the experts' responses to ten open-ended questions. In the 2nd Delphi round, 59.2% of these items were accepted as pre-recommendation. In the 3rd Delphi round, 62.6% of 246 items were accepted for inclusion in the proposals. The final version recommendations consisted of 154 items. CONCLUSIONS: This study includes comprehensive and detailed answers for every problem that could be posed in clinical practice for the management of PD, and recommendations are for all pediatric patients with both oropharyngeal and esophageal dysphagia.
Authors: Praveen S Goday; Susanna Y Huh; Alan Silverman; Colleen T Lukens; Pamela Dodrill; Sherri S Cohen; Amy L Delaney; Mary B Feuling; Richard J Noel; Erika Gisel; Amy Kenzer; Daniel B Kessler; Olaf Kraus de Camargo; Joy Browne; James A Phalen Journal: J Pediatr Gastroenterol Nutr Date: 2019-01 Impact factor: 2.839