A Systematic Review of Current Clinical and Instrumental Swallowing Assessment Methods

Tests for dysphagia serve as either assessment or screening tools. To be clinically useful these tools must be reliable, validated with proper psychometric techniques, and feasible. In a previous systematic review, only two screening tools met these criteria from the studies in stroke patients. There are no such systematic reviews assessing the availability and methodological quality of bedside or instrumental diagnostic assessment tools for dysphagia. This systematic review of recent literature identified 13 articles that have targeted development of new dysphagia tools, seven of which related to screening, five to clinical assessment, and one to instrumental assessment. Across all articles, critical appraisal revealed that none of the recent articles addressing screening, clinical or instrumental assessment had sufficient methodological rigor, and therefore readiness, for implementation into clinical practice. To ensure the best in patient care, it is necessary to develop tools with methodological rigor for all patient groups with dysphagia, beyond just screening. Future studies of patients with dysphagia must use prospective controlled study designs and only available tools that are reliable, valid and feasible. The development and testing of any new tools must ensure that they are also reliable, valid and feasible.