Prevalence of Oropharyngeal Dysphagia in Adults in Different Healthcare Settings: A Systematic Review and Meta-analyses.

The search covered only two databases (Embase and PubMed) and English-language publications, so relevant studies may have been missed. Only 22 of the 44 studies could be pooled. The rehabilitation estimate rests on 2 studies and the nursing home estimate on 3. The studies defined dysphagia differently, and disagreed about what counts as screening versus clinical assessment, so the pooled figures combine measures that are not really the same thing. More than half the included studies (26 of 44) used screening or assessment tools the authors made up or modified, with no information on how accurately they detect dysphagia. Most included studies were in stroke patients in hospital, which limits how far the figures apply to other patient groups. Patients receiving end-of-life care were excluded from six of the included studies, and no study from a palliative care setting met the inclusion criteria. The authors themselves state that caution should be used in interpreting the pooled results because of the heterogeneity between studies.

The paper names two funders, Helse Sor-Ost RHF and the University of Gothenburg. No competing-interest declaration is included in the text supplied. The authors state that bias is not expected because the reviewers were not affiliated with any of the authors of the included studies.

Do not read the pooled figures as the rate you will find on your own caseload. Individual hospital studies in this review ranged from 6% to 82.4% depending on the test and the definition of dysphagia they used, more than half used tools with no published accuracy data, and the nursing home estimate rests on only three studies.