title: Swallowing screens after acute stroke: a systematic review.
abstract: OBJECTIVE
  Swallowing screens after acute stroke identify those patients who do not need a formal swallowing evaluation and who can safely take food and medications by mouth. We conducted a systematic review to identify swallowing screening protocols that met basic requirements for reliability, validity, and feasibility.
  
  
  METHODS
  We searched MEDLINE and supplemented results with references identified through other databases, journal tables of contents, and bibliographies. All relevant references were reviewed and evaluated with specific criteria.
  
  
  RESULTS
  Of 35 protocols identified, 4 met basic quality criteria. These 4 had high sensitivities of ≥87% and high negative predictive values of ≥91% when a formal swallowing evaluation was used as the gold standard. Two protocols had greater sample sizes and more extensive reliability testing than the others.
  
  
  CONCLUSIONS
  We identified only 4 swallowing screening protocols for patients with acute stroke that met basic criteria. Cost-effectiveness of screening, including costs associated with false-positive results and impact of screening on morbidity, mortality, and length of hospital stay, requires elucidation.
authors.affiliation: Department of Neurology, University of Washington, Seattle, Washington, USA. skschepp@uw.edu
authors.forename: Sara K
authors.initials: SK
authors.lastname: Schepp
authors.forename: David L
authors.initials: DL
authors.lastname: Tirschwell
authors.forename: Robert M
authors.initials: RM
authors.lastname: Miller
authors.forename: W T
authors.initials: WT
authors.lastname: Longstreth
mesh_terms: D002983:Clinical Competence; D002985:Clinical Protocols; D003679:Deglutition / Q000502:physiology*; D004435:Eating; D005240:Feasibility Studies; D006801:Humans; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D020521:Stroke / Q000175:diagnosis*