Developing an App-Based Voice Clinical Decision Support Tool to Augment the Sensitivity of the Bedside Swallow Evaluation in Older Adults

开发基于应用程序的语音临床决策支持工具，以提高老年人床边吞咽评估的灵敏度

• 批准号: 10676194
• 负责人: Anais Rameau
• 金额: $ 24.29万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-04 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10676194
• 关键词: Acoustics; Address; Adult; Advocacy; Affect; Aging; Alzheimer' s disease related dementia; Aspiration Pneumonia; Barium swallow; Behavioral Research; Biological Markers; Caring; Cause of Death; Cellular Phone; Characteristics; Clinical; Collaborations; Coughing; Data; Deglutition; Deglutition Disorders; Dehydration; Dental Hygiene; Detection; Elderly; Environment; Evaluation; Evidence based treatment; Exercise; Fellowship; Food; Foundations; Functional disorder; Funding; Geriatrics; Goals; Grant; Head and Neck Surgery; Health Care Costs; Human; Individual; Institution; Language; Leadership; Length of Stay; Lung; Machine Learning; Malnutrition; Mentors; Mentorship; Methods; Morbidity - disease rate; Nurses; Nursing Assessment; Nursing Homes; Oral; Otolaryngologist; Otolaryngology; Pathologist; Patients; Perception; Performance; Pharyngeal structure; Pilot Projects; Protocols documentation; Research; Research Personnel; Risk; Site; Specialist; Speech; Standardization; Techniques; Technology; Testing; United States National Institutes of Health; Vision; Voice; aspirate; canine model; career; career development; clinical decision support; cohort; cost; curriculum development; dietary; digital; experience; flexibility; frailty; high risk; human old age (65+); improved; improved outcome; interdisciplinary collaboration; interest; medical schools; mobile application; mortality risk; novel strategies; prospective; skills; smartphone application; sound; support tools; tool; treatment strategy; vocal cord

PROJECT SUMMARY/ABSTRACT The over-arching goals of Dr, Rameau's Beeson application are (1) to develop an easy-to-use, highly accurate bedside clinical decision support tool to identify swallowing dysfunction in older adults using analysis of features of their recorded voice, cough and speech, and (2) to become a leader in the nascent field of geriatric otolaryngology with a focus on management of speech and swallowing issues in older adults with Alzheimer's disease and related dementias (AD/ADRD). Candidate: The applicant, Dr. Anaïs Rameau, is an otolaryngologist at Weill Cornell Medical College (WCMC) who has demonstrated significant research ability and clinical interest in geriatric otolaryngology, especially in the care of older adults with dysphagia. Dr. Rameau's long-term career goal is to become an independent researcher and academic leader in geriatric dysphagia. She already laid significant foundations towards this goal, developing close mentorship relationships, gaining broad research, clinical, management and leadership skills, and experience as PI on multiple institutional and foundation grants. Mentors: To achieve her objectives, Dr. Rameau has engaged an exceptional, transdisciplinary team of mentors, who are highly successful, NIH-funded investigators and well-recognized leaders and experts in their respective fields. Her mentorship team includes Dr. Mark Lachs, Co-Director of the WCMC Division of Geriatrics, Dr. Michael Stewart, Chair of the WCM Department of Otolaryngology – Head & Neck Surgery, and Dr. Sara Czaja, Director of the Center on Aging and Behavioral Research at WCM. Research: In collaboration with bio-acousticians at the Cornell Lab of Ornithology, our research, both in an excised canine model and a human pilot study, has suggested that conventional acoustic metrics of voice and cough sound differ in important ways between patients with and without aspiration risk. These characteristics may serve as biomarkers of dysphagia, and acoustic analysis of the patient's digitally recorded voice and cough has the potential to effectively differentiate between normal and abnormal swallowing. Including multiple characteristics, such as those specifically evaluating oral frailty, and combining the results may increase accuracy of swallowing dysfunction identification, especially in older adults with AD/ADRD who are more prone to silent aspiration. Adding non-linear methods and machine learning to conventional acoustic analysis may also improve accuracy. Dr. Rameau proposes to use these techniques to develop a clinical decision support tool that incorporates analysis of multiple characteristics of a patient's recorded voice and cough to determine their aspiration risk. To increase the potential for use of this tool at the bedside, she will modify it for recordings on a smartphone as part of a mobile application. Upon completion of this research, she plans to submit an R01 to prospectively examine the performance of the clinical decision support tool in a multi-site RCT in large, diverse cohort of older adults.

项目摘要/摘要 Rameau的Beeson应用程序的总体目标是（1）开发一种易于使用的，高度的 精确的床边临床决策支持工具，使用分析识别老年人吞咽功能障碍 他们记录的声音，咳嗽和语音的特征，以及（2）成为新生领域的领导者 老年耳鼻喉科，专注于管理语音和吞咽问题的老年人 阿尔茨海默氏病和相关痴呆症（AD/ADRD）。 候选人：申请人AnaïsRameau博士是Weill Cornell医学院（WCMC）的一名otrolyngologgers 他在老年耳鼻喉科方面表现出了重要的研究能力和临床兴趣，尤其是 患有吞咽困难的老年人的护理。拉莫博士的长期职业目标是成为独立 老年吞咽困难的研究人员兼学术领导者。她已经为此奠定了重要的基础 目标，建立紧密的心态关系，获得广泛的研究，临床，管理和领导力 技能，以及在多个机构和基础赠款中作为PI的经验。 导师：为了实现她的目标，拉莫博士与一个非凡的跨学科团队合作 指导者，非常成功，资助的调查人员以及公认的领导者和专家 她的指导团队包括WCMC部门联合主任Mark Lachs博士 WCM耳鼻喉科部主席Michael Stewart博士 - 头部和颈部手术， WCM老化与行为研究中心主任Sara Czaja博士。 研究：与康奈尔（Cornell）鸟类学实验室的生物声学家合作，我们的研究都在 出色的犬类模型和人类试点研究表明，语音和语音的常规声学指标和 咳嗽的声音在患有和没有抽吸风险的患者之间的重要方面听起来有所不同。这些特征 可以用作吞咽困难的生物标志物，以及对患者数字记录的声音的声学分析 咳嗽有可能有效地区分正常吞咽和异常。包括多个 特征，例如专门评估口服脆弱的特征，结合结果可能会增加 吞咽功能障碍识别的准确性，尤其是在AD/ADRD的老年人中更容易发生的 沉默的愿望。将非线性方法和机器学习添加到常规的声学分析可能 也提高准确性。拉莫博士的提议使用这些技术来建立临床决策支持 包括对患者记录的语音和咳嗽的多种特征分析的工具，以确定 他们的志向风险。为了增加在床边使用此工具的潜力，她将修改它以进行录音 作为移动应用程序的一部分，在智能手机上。这项研究完成后，她计划提交R01 前瞻性地检查临床决策支持工具在多站点RCT中的性能 多样的老年人队列。

项目成果

Outcomes of Gender-Affirming Voice and Communication Modification Training for Non-binary Individuals: A Case Series.

针对非二元个体的性别肯定声音和沟通修改培训的结果：案例系列。

• DOI: 10.1016/j.jvoice.2023.08.005
• 发表时间: 2023
• 期刊: Journal of voice : official journal of the Voice Foundation
• 作者: Chadwick,KeithA;Liao,David;Alter,IsaacL;Coleman,Rachel;Andreadis,Katerina;Riekki,Rebecca;Waldman,Jack;Rives,Hal;Pitti,Mary;Rameau,Anaïs
• 通讯作者: Rameau,Anaïs

Should Injection Laryngoplasty Be Performed for Acute Unilateral Vocal Fold Paralysis to Improve Swallowing safety?

急性单侧声襞麻痹是否应进行注射喉成形术以提高吞咽安全？

• DOI: 10.1002/lary.30537
• 发表时间: 2023
• 期刊: The Laryngoscope
• 作者: Yiu,Yin;Gorelik,Daniel;Rameau,Anaïs
• 通讯作者: Rameau,Anaïs

Trust in Machine Learning Driven Clinical Decision Support Tools Among Otolaryngologists.

• DOI: 10.1002/lary.31260
• 发表时间: 2024-01
• 期刊: The Laryngoscope
• 作者: Han Chen;Xiaoyue Ma;Hal Rives;Aisha Serpedin;Peter Yao;A. Rameau

Concurrent Validity of a Low-Cost Manometer for Objective Assessments of Respiratory Muscle Strength.

低成本压力计客观评估呼吸肌力量的同时有效性。

• DOI: 10.1002/lary.31106
• 发表时间: 2024
• 期刊: The Laryngoscope
• 作者: Curtis,JamesA;Mocchetti,Valentina;Rameau,Anaïs
• 通讯作者: Rameau,Anaïs

Correlations Between Anxiety and/or Depression Diagnoses and Dysphagia Severity.

焦虑和/或抑郁诊断与吞咽困难严重程度之间的相关性。

• DOI: 10.1002/lary.31164
• 发表时间: 2024
• 期刊: The Laryngoscope
• 作者: Doruk,Can;Mocchetti,Valentina;Rives,Hal;Christos,Paul;Rameau,Anaïs
• 通讯作者: Rameau,Anaïs