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Published on: March 1, 2015
Swallowing screens after acute stroke: a systematic review
Sara K Schepp1, David L Tirschwell, Robert M Miller
1Department of Neurology, University of Washington, Seattle, Washington, USA. skschepp@uw.edu
Stroke
|December 14, 2011
Summary
This systematic review identified only 4 reliable swallowing screening protocols for acute stroke patients. These validated tools help determine who can safely eat and take medication, reducing the need for formal evaluations.
Area of Science:
- Neurology
- Clinical Medicine
- Healthcare Quality
Background:
- Dysphagia is a common complication after acute stroke.
- Accurate swallowing screening is crucial for patient safety and efficient care.
- Existing screening protocols vary in quality and validation.
Purpose of the Study:
- To systematically review and identify swallowing screening protocols for acute stroke patients.
- To assess protocols based on reliability, validity, and feasibility.
- To determine which protocols meet basic quality requirements.
Main Methods:
- Comprehensive literature search of MEDLINE and other databases.
- Inclusion of references from journal tables of contents and bibliographies.
- Systematic evaluation of identified protocols using specific quality criteria.
Main Results:
- 35 swallowing screening protocols were initially identified.
- Only 4 protocols met the basic quality criteria for reliability, validity, and feasibility.
- The 4 validated protocols demonstrated high sensitivity (≥87%) and high negative predictive value (≥91%).
- Two protocols stood out due to larger sample sizes and more rigorous reliability testing.
Conclusions:
- A limited number of swallowing screening protocols meet essential quality standards for acute stroke.
- Further research is needed to elucidate the cost-effectiveness of these screening tools.
- The impact of swallowing screening on patient outcomes, including morbidity, mortality, and hospital stay, requires additional investigation.