Optimal Outcomes for Oropharyngeal Dysphagia

Abstract

Returning a patient with oropharyngeal dysphagia to a full, safe oral intake of a normal diet is optimal, but not always possible. With intervention, other optimal outcomes may exist along the patient’s specific trajectory of recovery or degeneration. The measurement points along the maximized trajectory of recovery through applied intervention are then patient-specific optimal outcomes. Measurement tools for dysphagia must be valid, reliable, and sensitive to diverse populations and capture clinically meaningful change. We suggest distinctive levels of quality for outcome measurement tools, and call for further research to determine appropriate outcome measures and meaningful end points in dysphagia management. The conceptual framework provided regarding optimal outcomes in dysphagia management can facilitate discussions regarding health care reform. Large clinical data sets and future research are needed to better define the trajectory of swallowing rehabilitation, a significant and positive deviation from the natural disease or illness course.