- Oropharyngeal dysphagia in adults
- Head and neck cancer
- Spinal cord injury
- Randomized controlled trials
- Outcome measurement
- Health service delivery
- Knowledge transfer
Dr. Martino's research focuses on understanding swallowing impairment and its impact on the patient. She has developed a tool called the Toronto Bedside Swallowing Screening Test (TOR-BSST(c)), by which stroke patients can be screened for the presence of swallowing difficulties within 24 hours of acute hospital admission. The premise of the TOR-BSST(c) is that earlier identification will initiate earlier intervention, and thereby reduce the incidence of medical complications such as pneumonia, malnutrition and even death while at the same time promoting earlier overall recovery. Through funding from the Canadian Stroke Network (CSN), as well as Canadian Institutes of Health Research (CIHR) New Investigator Award (in Knowledge Translation), Ontario Ministry of Health and Long-Term Care (MOHLTC), and the University of Toronto Dean's Fund, Dr. Martino has developed and validated the TOR-BSST(c) for use among stroke patients, and studied its implementation at 14 community hospitals and 2 long-term care facilities. Currently, Dr. Martino is validating the TOR-BSST(c) among critically ill patients who have been intubated for 48 hours or longer, with funding from a CIHR operating grant awarded in 2011.
In addition, Dr. Martino has developed another tool targeting the medical outcomes of dysphagia (MOD). The MOD measures complications caused by swallowing problems -- namely pulmonary, nutrition and psychological impairments. The MOD is the first available to measure these complications in a standard and clinically feasible manner. This tool will benefit all patients with swallowing problems including those with stroke, Parkinson's diseasecervical spine abnormalities, and head and neck cancer. The MOD will be important to clinicians because it will be the first to allow them to evaluate and compare patient benefit from swallowing treatments. In 2005, Dr. Martino was awarded a New Investigator Award from the Canadian Institutes of Health Research (CIHR) Institute of Aging to further the development of the MOD tool. In 2009, she was also awarded operating grants from CIHR and the Canadian Cancer Society Research Institute (CCSRI) to carry out psychometric testing of the MOD in adult patients who have swallowing disorders secondary to stroke, cervical spine abnormalities, and head and neck cancer.
Dr. Martino is also Co-Principal Investigator on a swallowing substudy of a large multi-centre phase 3 trial comparing two combination drug-radiation therapies in head and neck cancer patients. The substudy will use a newly validated tool, called the MBSImP, to measure swallowing impairment in these patients. Feasibility and inter-rater reliability of the tool will be assessed, and impairment findings in both treatment groups will help to identify future research questions.
Dr. Martino has a lab at the University of Toronto and a lab at the Toronto Western Research Institute within the University Health Network. She works with a Research Coordinator, Research Assistants and several Speech-Language Pathology clinicians and students. Currently, she is the primary supervisor of three PhD students.