Dysphagia最新文献

{"title":"Effects of Combined Repetitive Transcranial Magnetic Stimulation and Chin-tuck Against Resistance Dual Stimulation on Swallowing: An fNIRS and EMG Study.","authors":"Jihai Peng, Siyu Huang, Wenlin Zhang, Ke Er Chen, Xiaoman Chen, Qian Ding, Guangqing Xu","doi":"10.1007/s00455-025-10847-x","DOIUrl":"https://doi.org/10.1007/s00455-025-10847-x","url":null,"abstract":"<p><p>To simultaneously perform dual stimulation (DS) through repetitive transcranial magnetic stimulation (rTMS) and resistance training of the target muscle group (submental muscles) using chin-tuck against resistance (CTAR), with the aim of observing via functional near-infrared spectroscopy (fNIRS) and surface electromyography studies whether rTMS and CTAR dual stimulation can maximize cerebral blood oxygenation and brain connectivity changes, as well as submental muscle contraction function, thus enhancing swallowing function and providing a new treatment method to reduce clinical swallowing disorder patients' risk of aspiration. Forty age-matched healthy participants were enrolled and assigned to four groups: the first group received no intervention, the second group received 5-Hz single stimulation via rTMS on the dominant hemisphere M1; the third group received simultaneous 5-Hz rTMS on the dominant hemisphere M1 with active resistance movement DS of the submental muscles; the last group received single stimulation via CTAR; all participants were assessed before and after stimulation through fNIRS to measure cerebral hemodynamics for evaluating differences in brain area activation and functional connectivity during resting and task states. Differences in the root mean square amplitude (RMS) of the submental muscle group among the four groups were also analyzed. DS group channels 24 and 51 showed higher cortical activation; also increased connectivity from the left frontal lobe to the right parietal lobe. In bilateral submental muscle groups, RMS after intervention was significantly reduced in DS group and CTAR group, while there was no significant difference between TMS group and control group. In conclusion, dual stimulation of rTMS combined with CTAR can significantly activate the cerebral cortex, increase brain connectivity and reduce RMS in the rehabilitation of dysphagia, which is a promising treatment method and provides a basis for non-invasive research of fNIRS.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Active Interferential Current Stimulation on Swallowing Function in Patients with Dysphagia: A Cross-Sectional Study of Interferential Current Stimulation on Swallowing Function in Patients with Dysphagia: A Cross-Sectional Study.","authors":"Shinsuke Nagami, Masayuki Kouda, Katsuya Nakamura, Yuhei Kodani, Naoya Obama, Ayaka Yokozeki, Kazuhiro Wakamatsu, Masanori Hirobayashi","doi":"10.1007/s00455-025-10853-z","DOIUrl":"https://doi.org/10.1007/s00455-025-10853-z","url":null,"abstract":"<p><p>Dysphagia is prevalent among elderly and neurologically impaired individuals, causing serious complications such as aspiration pneumonia. Interferential Current Stimulation (IFC), a non-invasive sensory method, may improve swallowing by reducing reflex latency. This study aimed to investigate the effects observed during active IFC stimulation of IFC on swallowing function using Laryngeal Elevation Delay Time (LEDT), Stage Transition Duration (STD), and Penetration-Aspiration Scale (PAS). Forty-six participants (ages 29-98) undergoing videofluoroscopic swallowing studies received IFC stimulation with electrodes bilaterally placed on the thyroid cartilage. Swallowing parameters were analyzed frame-by-frame using ImageJ software. LEDT measured the time from contrast arrival at the bottom of the piriform sinus to maximum laryngeal elevation. STD was the interval from oral bolus transit to pharyngeal swallow initiation. PAS assessed penetration and aspiration severity. LEDT significantly improved from baseline (median [IQR]: 0.15 [0.00-0.35] s) to 10 min during IFC stimulation (0.00 [0.00-0.19] s; p = 0.02, r = 0.46, 95% CI [0.11-0.76]). No significant changes were found in STD (STD1: p = 0.37; STD2: p = 0.37) or PAS scores (PAS1: p = 0.20; PAS2: p = 0.71). Responder analysis indicated substantial individual variability: approximately 70% improved in LEDT, while only 37-45% improved in STD. Higher responder rates were noted among participants with respiratory and cerebral disorders. IFC stimulation significantly shortened swallowing reflex latency (LEDT), suggesting its potential benefit for dysphagia rehabilitation. However, it did not significantly alter stage transition duration (STD) or penetration-aspiration safety (PAS). Further studies should explore long-term effects and optimal stimulation parameters.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Telemedicine on Dysphagia Rehabilitation in Patients Requiring Home Care: A Retrospective Study.","authors":"Rieko Moritoyo, Kazuharu Nakagawa, Kanako Yoshimi, Kohei Yamaguchi, Yuki Nagasawa, Ryosuke Yanagida, Koji Hara, Haruka Tohara","doi":"10.1007/s00455-025-10844-0","DOIUrl":"https://doi.org/10.1007/s00455-025-10844-0","url":null,"abstract":"<p><p>This study investigated telemedicine as an alternative to home-visit medical care (HMC) when HMC for patients with dysphagia was suspended. This retrospective study assessed whether telemedicine reduced adverse events compared to suspending care during the initial 3 months of the coronavirus pandemic. Seventy-six HMC patients were enrolled. Those who received telemedicine formed the telemedicine group (TG), and those who declined comprised the suspended group (SG). Baseline data and adverse events, including whole-body and dysphagia-related adverse events, were analyzed using the Mann-Whitney U-test, Fisher's exact test, and binomial logistic regression. Of the 76 patients, 20 were in TG and 56 in SG. Telemedicine consultations' frequency was 1-3. Significant baseline differences occurred in the Charlson Comorbidity Index (CCI) and caregiver type. In the TG and SG, 0% and 12.5% of patients experienced whole-body adverse events and 10.0% and 33.9% had dysphagia-related adverse events, respectively. Dysphagia-related adverse events were significantly lower in TG (p = 0.046). Telemedicine was significantly associated with fewer dysphagia-related adverse events after adjusting for age, CCI, and Dysphagia Severity Scale (p = 0.040). Telemedicine effectively supplemented in-person dysphagia rehabilitation, enabling continued monitoring and reducing complications, although patient self-selection and caregiver support may have influenced outcomes.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Use of Pill Swallowing in Dysphagia Assessment: A Survey of Common Practices.","authors":"Meg Wood, Mary Gorham-Rowan, Ruth Renee Hannibal, Katherine Lamb, Michelle Cox","doi":"10.1007/s00455-025-10846-y","DOIUrl":"https://doi.org/10.1007/s00455-025-10846-y","url":null,"abstract":"<p><p>Pill swallowing and medication administration can be problematic in patients with difficulty swallowing and can lead to poor medication compliance. The extent to which speech-language pathologists (SLPs) consider pill swallowing during videofluorographic assessments, however, is not known. A survey focusing on SLP practices, knowledge, and opinions about assessment of pill swallowing and subsequent medication administration decisions in patients with dysphagia was distributed to SLPs via American Speech-Language-Hearing Association (ASHA) special interest divisions and an online forum. Results from the survey revealed that while 53% of respondents agreed that pill swallowing should be included during dysphagia assessment, only 28% routinely do so. However, 58% of the SLPs reported making recommendations regarding medication administration based on the results of the videofluorographic exam. Further research should focus on best practices for pill swallowing assessment as well as exploring interventions for pill swallowing difficulty within the dysphagic population so that adverse events can be minimized, and patient outcome maximized.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Feeding-swallowing Impact Survey: Reference Values from a UK Sample of Parents of Children Without a Known or Suspected Feeding Disorder.","authors":"Alexandra Stewart, E Van Hoeve, A Mustafa, M A Lefton-Greif, D Ridout, C H Smith","doi":"10.1007/s00455-025-10845-z","DOIUrl":"https://doi.org/10.1007/s00455-025-10845-z","url":null,"abstract":"<p><p>The feeding swallowing impact survey (FS-IS) is an 18-question, 3 subscale, validated tool measuring parent/caregiver impact of children's eating, drinking and swallowing difficulties. This study aimed to establish reference values from parents of children without known or suspected paediatric feeding disorder for the FS-IS. Parents of children aged 6 months-11 years were invited to complete an anonymous, online questionnaire. The Pedi-EAT-10 was used to screen for pediatric feeding disorder. For the FS-IS average and cumulative scores were calculated for the whole scale and subscales. Percentile rankings were calculated for the cumulative whole scale score. The relationship between variables was explored using Spearman's correlation and 75th centile quantile regression. The final sample consisted of 904 parents. Median (IQR) whole scale score was 1.11 (1.06, 1.22), from a possible range of 1-5.. Percentile rank scores were: 5th = 18, 25th = 19, 50th percentile = 20, 75th = 22 and 95th = 29, from a possible range of 18-70. Parent perception of a feeding difficulty was the factor associated with greatest score increase. These data provide UK reference data for the FS-IS, facilitating its use in the evaluation of parental impact of feeding difficulties, a key component of holistic, family-centred care. Feeding-related QOL is largely unaffected in caregivers of children without a diagnosed or suspected pediatric feeding disorder.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Transfer Learning for the Automated Segmentation and Detection of Swallows via Digital Cervical Auscultation in Children.","authors":"Stephen So, Timothy Tadj, Belinda Schwerin, Anne B Chang, Thuy T Frakking","doi":"10.1007/s00455-025-10833-3","DOIUrl":"https://doi.org/10.1007/s00455-025-10833-3","url":null,"abstract":"<p><p>Digital cervical auscultation (CA) has high diagnostic test accuracy in the detection of aspiration in children. However, the clinical application of digital CA is limited because swallow sound recordings require manual segmentation by trained experts, which is time consuming and not feasible in clinical practice. The automated detection of swallowing sounds in adults from sound recordings have reported accuracies between 76 and 95%. No equivalent literature exists for the automated detection of swallowing sounds in children. This study aimed to establish whether automated machine learning using a transfer learning approach can accurately detect and segment swallows from digital CA recordings in children. Swallow sounds were collected from 16 typically developing children, median age 18 months (range 4-35 months, 50% males); and 19 videofluoroscopic swallow studies of children with pediatric feeding disorders, median age 9 months (range 3-71 months, males 36.8% males). All swallowing sounds were on thin fluids. A deep convolutional neural network (DCNN) that was pre-trained for the task of audio event classification was used as the base machine learning model. Using the raw swallow audio data as input, embedding vectors from the base DCNN were computed and used to train a feedforward neural network to identify whether an audio segment was a swallow or not. A high overall accuracy of 91% was achieved using our model, with a sensitivity (or recall) and positive predictability (or precision) of 81% and 79%, respectively. Interestingly, the model was also able to detect saliva swallows in the clinical feeding evaluation test set, even though these non-nutritive swallows were not part of the training set. This indicates a level of generalizability of the model, where it was able to recognize swallowing events that it had not \"seen\" before. Our study provides the highest accuracy reported to date on the automatic segmentation and detection of swallowing sounds in children.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revealing Goal-Directed Neural Control of the Pharyngeal Phase of Swallowing.","authors":"Shahryar Zainaee, Brent Archer, Ronald Scherer, Verner Bingman, Mehran Ghasemi","doi":"10.1007/s00455-024-10758-3","DOIUrl":"10.1007/s00455-024-10758-3","url":null,"abstract":"<p><p>Swallowing is considered a three-phase mechanism involving the oral, pharyngeal, and esophageal phases. The pharyngeal phase relies on highly coordinated movements in the pharynx and larynx to move food through the aerodigestive crossing. While the brainstem has been identified as the primary control center for the pharyngeal phase of swallowing, existing evidence suggests that the higher brain regions can contribute to controlling the pharyngeal phase of swallowing to match the motor response to the current context and task at hand. This suggests that the pharyngeal phase of swallowing cannot be exclusively reflexive or voluntary but can be regulated by the two neural controlling systems, goal-directed and non-goal-directed. This capability allows the pharyngeal phase of swallowing to adjust appropriately based on cognitive input, learned knowledge, and predictions. This paper reviews existing evidence and accordingly develops a novel perspective to explain these capabilities of the pharyngeal phase of swallowing. This paper aims (1) to integrate and comprehend the neurophysiological mechanisms involved in the pharyngeal phase of swallowing, (2) to explore the reflexive (non-goal-directed) and voluntary (goal-directed) neural systems of controlling the pharyngeal phase of swallowing, (3) to provide a clinical translation regarding the pathologies of these two systems, and (4) to highlight the existing gaps in this area that require attention in future research. This paper, in particular, aims to explore the complex neurophysiology of the pharyngeal phase of swallowing, as its breakdown can lead to serious consequences such as aspiration pneumonia or death.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"528-540"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Evaluation for Oropharyngeal Dysphagia in Non-institutionalized Elderly Patients with Home Care-based in the Community.","authors":"Lorena Montero, Àngela Fauró, Gemma Gómis, Rocío Rodríguez-Romero, Susana Santos-Ruiz, Miriam Aguilar, Alicia Alcaraz, Meritxell Devant-Altimir, Nuria I García, Elena Gómez, Noelia García, Lucía Guerrero, Alejandro Lascorz, Eva Martínez, María T Muntalà, Jana Pujol, Amaya Serna, Laura Sibelo, Melba Vázquez, Silvia Roura-Rovira, Luis González-de Paz","doi":"10.1007/s00455-024-10761-8","DOIUrl":"10.1007/s00455-024-10761-8","url":null,"abstract":"<p><p>Oropharyngeal Dysphagia (OD) increases the risk of hospitalization and the use of health services; however, it is often detected and studied in institutionalized patients with limited attention given to the community. The aim of this study was to determine the prevalence of OD and its associated factors after conducting a program consisting of a systematic assessment of OD for in patients living independently in their dwellings and requiring home-based care. We conducted a cross-sectional study involving a systematic assessment of disabled and elderly patients enrolled in a home-based primary care program at three urban centers (Barcelona, Spain). OD was assessed using the Volume-Viscosity Swallow Test. Data on morbidity, incontinence, functional independence, pressure sore risk, brain deficit, social risk, nutritional status, and healthcare utilization were collected. Prevalence was determined, and differences between OD and non-OD patients were analysed using independent tests. Associations between OD and hospital admissions, emergency department visits, emergency home ambulance use, and consultations with family physicians or primary care nurses were examined using logistic regression models adjusted for covariates. We included 1,002 patients with a mean age of 88.75 years old (SD = 8.19), 73.05% of whom were female. The prevalence of OD was 25.95% (95% CI 23.26%-28.78%). OD was associated with past pneumonia episodes (adjusted OR: 5.09, 95% CI: 2.2-11.79), increased frequency of cough and common cold (adjusted OR: 1.11, 95% CI: 1.05-1.18), and more family physician consultations (adjusted OR: 1.07, 95% CI: 1.03-1.10). These findings highlight that OD remains an underdiagnosed geriatric syndrome in the community setting. Implementing systematic OD diagnoses assessments, especially among home care-based patients could reduce the incidence of secondary pneumonia, decrease cough episodes, and lower the frequency of clinician consultations.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"607-613"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eating and Drinking with Acknowledged Risks (EDAR) in Older Adults: A Qualitative Study of the Experiences of Clinicians in Japan and the UK.","authors":"Yuki Yoshimatsu, Marianne Markowski, David G Smithard, Dharinee Hansjee, Tadayuki Hashimoto, Hiroyuki Nagano, Ryan Essex","doi":"10.1007/s00455-024-10765-4","DOIUrl":"10.1007/s00455-024-10765-4","url":null,"abstract":"<p><p>Eating and drinking are fundamental to life. However, older patients are often restricted with oral intake due to feared risk of aspiration. Eating and Drinking with Acknowledged Risks (EDAR) is an alternative process which enables comfort, dignity, and autonomy for these patients. While national guidance has been developed for EDAR in the UK, other ageing societies such as Japan do not have such guidance. To understand the perspectives and experiences of healthcare professionals regarding the complex decision-making process around EDAR we planned a mixed methods study comparing the two countries. This was the qualitative phase of the study. Twelve healthcare professionals (two doctors, nurses and speech and language therapists each in Japan and the UK) participated in semi-structured interviews on their roles and experiences related to EDAR in older adults. We analysed the data thematically, and three themes emerged: (1) healthcare professionals and healthcare systems, (2) priorities in decision-making and (3) relationship with family and patient. There were many similarities but also differences across the countries, in the setting, training and individual experience. Decision-making was shaped by a complex combination of individual, structural and cultural factors, which indicated in the Japanese culture a greater likeliness to defer clinical decision-making and to side with families' wishes. Healthcare professionals' experiences and attitudes towards EDAR differed depending on various factors related with the individual and environment. The next quantitative phase of our research aims to establish the mechanism to increase confidence around EDAR in professionals and training options.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"650-659"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence of Clinical Practice Guidelines for Oropharyngeal Dysphagia in Parkinson Disease to Trustworthy Standards: A Systematic Survey.","authors":"Pooja Gandhi, Wimonchat Tangamornsuksan, Rachel Couban, Gordon H Guyatt, Catriona M Steele, Connie Marras","doi":"10.1007/s00455-024-10755-6","DOIUrl":"10.1007/s00455-024-10755-6","url":null,"abstract":"<p><p>Despite the high prevalence and burden of dysphagia in Parkinson disease (PD), the availability and trustworthiness of clinical practice guidelines (CPGs) regarding its assessment and management remains uncertain. The objective of this study is to appraise the quality of CPGs for dysphagia in PD. We searched OVID Medline, Embase, CINAHL and SpeechBite from January 2011 to July 2023 for guidance documents addressing screening, referral, monitoring, assessment, or management of dysphagia in PD. We additionally conducted an informal search of web pages of relevant professional societies and government organizations. Paired reviewers independently screened studies, and for relevant guidance documents, abstracted data and assessed their quality using the National Guideline Clearinghouse Extent of Adherence to Trustworthy Standards instrument. Thirteen CPGs proved eligible. Of these, eight (62%) were developed by professional societies. Overall, CPGs were deemed low quality. Eleven (85%) CPGs reported funding sources, and nine (69%) reported conflicts of interest. Five (35%) guidance documents included a methodologist, four (30%) included patient partners, four (30%) described study selection processes, and two (15%) clearly described relevant benefits and harms. Regarding dysphagia-specific recommendations, less than half of guidance documents met standards for trustworthiness; six (46%) provided a synthesis of available evidence, eight (54%) specified strength of recommendations, and two (15%) articulated unambiguous recommendations. Limited guidance exists regarding screening, monitoring and referral for dysphagia in PD. Existing guidance frequently fails to meet standards for trustworthiness. International, multidisciplinary, evidence-based practice guidelines with adequate methodological and patient partner involvement are needed.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"576-587"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}