Swallowing Screens After Acute Stroke: A Systematic Review
Stroke
Schepp, S. K., Tirschwell, D. L., et al. (2012).
Stroke, 43(3), 869-871.
This systematic review compares the reliability and validity of swallowing screening protocols for determining oral intake safety to gold standard formal swallowing evaluations in individuals with acute stroke.
National Institute of Neurologic Disease and Stroke
This systematic review was replicated and extended in 2013 by the following systematic review:<ul>
<li>Martino, R., Flowers, H., et al. (2013). A Systematic Review of Current Clinical and Instrumental Swallowing Assessment Methods. <i>Current Physical Medicine and Rehabilitation Reports, 1</i>(4), 267-279. doi: 10.1007/s40141-013-0033-y</li>
</ul>
Up to August 2011
Studies providing reliability data (not further specified)
4
<p>The authors found only four screening protocols that met basic quality criteria reliability, validity, and feasibility for use with acute stroke population. The following screening protocols had high sensitivity (87%-96%) and mixed specificity (56%-84%) compared to the gold standard of bedside swallowing evaluation or videofluoroscopy to determine risk for dysphagia:</p>
<ul>
<li>the Acute Stroke Dysphagia Screen;</li>
<li>Modified Mann Assessment of Swallowing Ability;</li>
<li>Emergency Physician Swallowing Screening; and</li>
<li>the Toronto Bedside Swallowing Screening Test.</li>
</ul>
<p>The authors reported that negative predictive values of screening protocols were 97% or greater. Negative predictive values ranged from 54% to 77% indicating that 23% to 77% of stroke patients were falsely identified at risk for dysphagia using protocol. Further research is warranted to determine evidence-base for use of screening protocols in acute stroke population.</p>
