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31 results on '"Starmer, Heather M."'

14. Dynamic Imaging Grade of Swallowing Toxicity (DIGEST): Scale development and validation

Author

Hutcheson, Katherine A., primary, Barrow, Martha P., additional, Barringer, Denise A., additional, Knott, Jodi K., additional, Lin, Heather Y., additional, Weber, Randal S., additional, Fuller, Clifton D., additional, Lai, Stephen Y., additional, Alvarez, Clare P., additional, Raut, Janhavi, additional, Lazarus, Cathy L., additional, May, Annette, additional, Patterson, Joanne, additional, Roe, Justin W. G., additional, Starmer, Heather M., additional, and Lewin, Jan S., additional

Published
2016
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27. Does Prosthesis Diameter Matter?

Author

Starmer, Heather M., primary, Agrawal, Nishant, additional, Koch, Wayne, additional, Richmon, Jeremy, additional, Webster, Kimberly, additional, and Gourin, Christine G., additional

Published
2011
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30. Dynamic Imaging Grade of Swallowing Toxicity (DIGEST): Scale development and validation.

Author

Hutcheson KA, Barrow MP, Barringer DA, Knott JK, Lin HY, Weber RS, Fuller CD, Lai SY, Alvarez CP, Raut J, Lazarus CL, May A, Patterson J, Roe JW, Starmer HM, and Lewin JS

Subjects
Deglutition Disorders physiopathology, Double-Blind Method, Female, Humans, Male, Middle Aged, National Cancer Institute (U.S.), Psychometrics methods, Quality of Life, Reproducibility of Results, Surveys and Questionnaires, United States, Barium administration & dosage, Deglutition physiology, Head and Neck Neoplasms physiopathology, Pharynx physiopathology
Abstract

Background: The National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) is the universal framework for toxicity reporting in oncology trials. The objective of this study was to develop a CTCAE-compatible modified barium swallow (MBS) grade for the purpose of grading pharyngeal dysphagia as a toxicity endpoint in cooperative-group organ-preservation trials for head and neck cancer (HNC). It was hypothesized that a 5-point, CTCAE-compatible MBS grade (Dynamic Imaging Grade of Swallowing Toxicity [DIGEST]) based on the interaction of pharyngeal residue and laryngeal penetration/aspiration ratings would be feasible and psychometrically sound., Methods: A modified Delphi exercise was conducted for content validation, expert consensus, and operationalization of DIGEST criteria. Two blinded raters scored 100 MBSs conducted before or after surgical or nonsurgical organ preservation. Intrarater and interrater reliability was tested with weighted κ values. Criterion validity against oropharyngeal swallow efficiency (OPSE), the Modified Barium Swallow Impairment Profile (MBSImP™©), the MD Anderson Dysphagia Inventory (MDADI), and the Performance Status Scale for Head and Neck Cancer Patients (PSS-HN) was assessed with a 1-way analysis of variance and post hoc pairwise comparisons between DIGEST grades., Results: Intrarater reliability was excellent (weighted κ = 0.82-0.84) with substantial to almost perfect agreement between raters (weighted κ = 0.67-0.81). DIGEST significantly discriminated levels of pharyngeal pathophysiology (MBSImP™©: r = 0.77; P < .0001), swallow efficiency (OPSE: r = -0.56; P < .0001), perceived dysphagia (MDADI: r = -0.41; P < .0001), and oral intake (PSS-HN diet: r = -0.49; P < .0001)., Conclusions: With the development of DIGEST, the MBS rating has been adapted to the CTCAE nomenclature of ordinal toxicity grading used in oncology trials. DIGEST offers a psychometrically sound measure for HNC clinical trials and investigations of toxicity profiles, dose responses, and predictive modeling. Cancer 2017;62-70. © 2016 American Cancer Society., Competing Interests: DISCLOSURES: The authors made no disclosures., (© 2016 American Cancer Society.)

Published
2017
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31. Prevalence, characteristics, and management of swallowing disorders following cerebellopontine angle surgery.

Author

Starmer HM, Best SR, Agrawal Y, Chien WW, Hillel AT, Francis HW, Tamargo RJ, and Akst LM

Subjects
Academic Medical Centers, Adult, Aged, Aged, 80 and over, Cerebellopontine Angle pathology, Cohort Studies, Combined Modality Therapy, Deglutition Disorders etiology, Deglutition Disorders physiopathology, Female, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Neuroma, Acoustic pathology, Neurosurgical Procedures methods, Postoperative Complications epidemiology, Postoperative Complications pathology, Postoperative Complications therapy, Prevalence, Prognosis, Retrospective Studies, Risk Assessment, Treatment Outcome, Young Adult, Cerebellopontine Angle surgery, Deglutition Disorders epidemiology, Deglutition Disorders therapy, Neuroma, Acoustic surgery, Neurosurgical Procedures adverse effects
Abstract

Objective: To describe swallowing disorders encountered after cerebellopontine angle surgery and to explore variables associated with increased incidence of postoperative dysphagia., Study Design: Case series with chart review., Setting: Single academic medical institution., Subjects and Methods: Chart review of 181 consecutive patients undergoing surgical excision of cerebellopontine angle pathology from January 2008 to December 2010 at the Johns Hopkins Hospital. Presence and characteristics of dysphagia were determined by review of speech pathologist reports. Other clinical variables were extracted from the electronic medical record, and statistical analyses were applied to determine factors associated with postoperative dysphagia., Results: Immediate postoperative dysphagia was identified in 57 of 181 patients (31%). Oral, oropharyngeal, and pharyngeal deficits accounted for 51%, 37%, and 12% of dysphagic symptoms, respectively. Facial nerve weakness in the immediate postoperative period was noted in 91% of dysphagic subjects compared with 43% of those without. Mean House-Brackmann score for dysphagic individuals was 4 compared with 2 in the nondysphagic group. Diet alterations were required for 65% of dysphagic individuals, and an additional 9% required tube feeding. Common findings during videofluoroscopic swallowing studies were pharyngeal residue, reduced pharyngeal constriction, and anterior bolus loss. Abnormal penetration-aspiration scores (≥3) were found in 59% of those undergoing videofluoroscopic swallow studies., Conclusions: Oral and pharyngeal swallowing deficits are commonly encountered after cerebellopontine angle surgery. Consultation with the speech-language pathologist appears most critical for any individuals demonstrating postoperative cranial nerve dysfunction, particularly for those with evidence of facial nerve weakness. Early consultation may help to manage short- and long-term functional difficulties.

Published
2012
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