Abstract
Dysphagia screening often includes administration of water. This study assessed the accuracy in identifying dysphagia with each additional teaspoon of water. The original research of the TOR-BSST© permitted this assessment. Trained nurses from acute and rehabilitation facilities prospectively administered the TOR-BSST© to 311 eligible stroke inpatients. A sensitivity analysis was conducted for the water item using 10 teaspoons plus a sip as the standard. The proportion of positive screenings was 59.2% in acute and 38.5% in rehabilitation. Of all four items that form the TOR-BSST©, the water swallow item contributed to the identification of dysphagia in 42.7% in acute and 29.0% in rehabilitation patients. Across all patients, dysphagia accuracy was that five teaspoons resulted in a sensitivity of 79% (95% confidence interval [CI] = 70–86), eight a sensitivity of 92% (95% CI = 85–96) and 10 a sensitivity of 96% (95% CI = 90–99). Although a primary contributor, the water swallow item alone does not identify all patients with dysphagia. For a water swallow to accurately identify dysphagia, it is critical to administer 10 teaspoons. The TOR-BSST© water swallow item contributes largely to the total TOR-BSST©'s screening score and in making the test highly accurate and reliable.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.