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Aphasia differential diagnosis - Coggle Diagram
Aphasia differential diagnosis
Defn
Process of asking series of qns aimed at reaching diagnostic conclusion
Allows us to unds nature of person's comm impairment
Allows us to concisely comm pt's comm profile to pt themselves, their fam, other health professionals
Assists w predicting prognosis
Helps determine whether person is suitable candidate for Tx
Assists w Tx planning
Clinical decision making
Gather info from client-referral, history, exam
Eval pt's subjective reports, evaluate test results
Find out if distinctive cluster of symptoms exists
Look for correlations among symptoms, signs
If info about course, eventual outcome of pt's condition is available--> consider what prognosis may be
Use all info to estimate effects on daily life
Integrate all info (from pt, clinical, scientific literature) to estimate potential effects of treatment
General guidelines for diagnosis
Ax should lead to an attempt at diagnosis
If a diagnosis cant be reached, need to state why it is difficult to do so, obsv that you have been able to make
Acceptable to provide statement regarding how likely the diagnosis is: probable, possible, most likely
Use clinically relevant research data to help determine sensitivities, specificity, likelihood ratios of each clinical feature, statistical probability of diagnosis
Determine presence or absence of aphasia, severity, type of aphasia/description of symptoms, co-occuring dysarthria/apraxia
Tips for case Hx interview
Do homework before seeing pt
Observe, record, meet w pt and fam
Conduct interview in quiet place
Introduce myself (how I fit into research team)
Leave contact info (photo)
Find out pt's story
Reassure
Pre-empt pt, fam for what comes next
Include fam members, significant others
What is needed
Learning about the pt
Comm abilities
Swallowing
Ax S&L impairment
Comm activities, participation
Personal factors
Env factors
Pt's well-being
Research
Flowers et al (2013):
250 pts w acute ischemic stroke, confirmed by MRI. Retrospective medical chart review. Estimates of incidence dysphagia (44%), dysarthria (42%), aphasia (30%). Highest co-occurence was 28% with dysphagia, dysarthria. 10% of pts had all 3 impairments