Assessing the validity of the Barwon health 121 dysphagia screening tool within an acute stroke population.

Abstract

Background: Multiple validated screening tools are available for dysphagia in acute stroke, with no evidence to clearly recommend any one. The Barwon Health 121 Dysphagia Screening Tool (121 screen) is appealing as it is fast, intuitively easy to follow and performed well in initial validation studies [1]. Aims: To assess the validity of the 121 screen against speech pathologist swallow assessment in a representative acute stroke population. Methods: During a 6 month introduction period, consecutive patients admitted with a diagnosis of acute ischaemic or haemor-rhagic stroke were assessed prospectively with both the 121 screen by trained nursing and medical staff and formal bedside swallow assessment by a speech pathologist. Results: One hundred and ten of one sixty one (66.26%) patients were screened of whom 107 received speech pathology swallow assessment. Screening rates improved from 50.6% (in the first 3 months) to 81.2% (in the second 3 months). The sensitivity and specificity were 87.1% and 92.1% respectively. Predictive value positive was 81.8% and predictive value negative 94.6%. All seven patients with pneumonia failed the screen. Discussion: The 121 Screen demonstrated good uptake and excellent validity in a representative acute stroke population. Health.<br />