Survey of Clinician Perspectives and Practices Regarding Swallowing-Related Fatigue
Bibliographic record
Abstract
Introduction Fatigue is commonly identified by clinicians who evaluate and treat swallowing impairment despite a lack of research in this area. The purpose of this study was to understand the current role of swallowing-related fatigue in dysphagia evaluation with respect to (a) clinician practices, (b) perspectives, and (c) desire for resources regarding swallowing-related fatigue. Method A survey was conducted by licensed speech-language pathologists who evaluate and treat adult dysphagia. The survey was distributed via dysphagia-focused groups on Facebook and Special Interest Group 13. Data were analyzed descriptively and by thematic analysis for free-text response questions. Results Out of 426 prospective respondents, 311 completed the survey (response rate = 73.0%). While 86% of respondents agreed that fatigue may be a concern for individuals with swallowing impairment, there was wide variability in how clinicians define and evaluate swallowing-related fatigue, and the majority (62%) define fatigue in two or more ways. Explicit evaluation of fatigue was reportedly conducted by 45% of respondents during the Clinical Swallowing Evaluation, by 38% during videofluoroscopic swallowing study, and by 53% during Flexible Endoscopic Evaluation of Swallowing. The most common methods for identifying fatigue were general declines in performance over the course of the assessment. Respondents reported much more reliance on patient report during Clinical Swallowing Evaluation (41%) compared to videofluoroscopic swallowing study (7%) and fiberoptic endoscopic evaluation of swallowing (5%). Only 7% of respondents reported being aware of any standardized methods for assessing fatigue, while 97% of respondents affirmed interest in incorporating standardized methods for assessing swallow-related fatigue. Conclusions Our results demonstrated wide variability in how currently practicing clinicians define and evaluate swallowing-related fatigue, despite the vast majority considering fatigue to be an important factor in dysphagia evaluation. This study highlights a critical gap in the clinical evaluation of swallowing and requires significant further study to guide clinical practice.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".