Summary of the Systematic Review

Article Citation

The Diagnostic Test Accuracy of Clinical Swallow Assessment for Oropharyngeal Aspiration: A Systematic Review

Romano, M., Schultz, T., et al. (2014).
The JBI Database of Systematic Reviews and Implementation Reports, 12(8), 259-329.
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Indicators of Review Quality

  • Yes The review states a clearly focused question/aim.
  • Yes Criteria for inclusion of studies are provided.
  • Yes Search strategy described in sufficient detail for replication.
  • Yes Included studies are assessed for study quality.
  • Yes Quality assessments are reproducible.
  • Yes Characteristics of the included studies are provided.

Article Details


This is a systematic review of the evidence and meta-analysis investigating the diagnostic accuracy of the clinical swallow assessment compared to the videofluoroscopic swallow study to assess oropharyngeal aspiration in adults and children.

Questions/Aims Addressed

What is the overall summary estimate of the diagnostic test accuracy of the clinical swallow assessment for detecting oropharyngeal dysphagia?


All adult and pediatric populations were included, with the exception of individuals with head and neck cancer, tracheostomy in situ, or craniofacial anomalies.


Any non-invasive assessment of swallowing and oral feeding skills used by clinicians

Number of Studies Included


Years Included

Up to April 2012

Conclusions from This Systematic Review

What are Conclusions?

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A number of clinical swallow assessments were reviewed, including: case history, cranial nerve assessment, food trials, and observation of clinical features at bedside. The findings of the review suggest that the clinical swallow assessment "is a reasonably accurate test for the assessment of aspiration in dysphagia patients" (p. 283). Overall summary of sensitivity and specificity were 71% and 76%, respectively, with the majority of participants studied diagnosed with stroke.

Keywords: Assessment of Clinical Features (e.g. Gag Reflex), Stroke

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"This paper highlights the lack of data available for diagnostic test accuracy of [the clinical swallow assessment] CSA in diagnosis of aspiration, for infants and children. This systematic review demonstrates that only one paper is available for this population. There [are] no data available for neurologically intact and normally developing children which is another area requiring research" (p. 284). 

Keywords: Early Intervention, Clinical Swallowing Examination

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