Already Finished?! Spring '13 and Summa Time Freedom

Six weeks flies by way too fast! I've just finished up my (very) short spring classes today and I have to say, I fell in love with my Dysphagia class. Six weeks was not long enough for that class and I would've happily taken it over the entire summer.

There were many things I really enjoyed learning about in this class, but I want to highlight the class project for dysphagia which was to collaborate with a classmate and develop an educational material for either SLPs, other medical staff, patients/clients, teachers, or anyone we could think of (one group designed a dysphagia book for children!). My partner and I decided to research pre-treatment swallowing exercises for patients undergoing chemo-radiation for head and neck cancer.

As we started to go through the literature we found some support for these exercises, but not much that would be considered Level I EBP. Only a few were randomized-control studies and many of those journal articles we found cited sample small sizes as the biggest limiting factor to definitively supporting pre-treatment swallowing exercises. A few others that we found only performed a retrospective review of case files which is at a level III EBP, and those studies tended to show that pre-treatment exercises were more useful than not. I am discovering that case file reviews are used quite often as well as small sample sizes and not enough randomized-control studies are often the norm in our profession. A quote from an SLP who sent me some information for this project sums up the problem quite nicely,  "I think this topic really gets at what Rosenbek refers to as 'the tyranny of the randomized control trial'.  In our profession (which lacks such evidence on most topics) it would be easy to do nothing because we don't have level 1 evidence for it."

I'm keeping an eye on a study currently underway at the University of Alabama that is looking to determine if pre-treatment swallowing exercises can improve