Validity and Reliability of the Swedish Version of the Gugging Swallowing Screen for use in Acute Stroke Care.

The screening and FEES assessments were done up to 96 hours after stroke or transient ischemic attack onset, while guidelines recommend screening within 24 hours or before oral intake, so the results may not match earlier screening. The sample size was not based on a dedicated power calculation, and the criterion validity table reports 60 participants while 80 were included and 75 underwent FEES. Most participants had mild stroke severity, with a median NIHSS score of 3, so the tool's accuracy in severe stroke is less certain. Inter-rater reliability was tested in only 30 patients, and intra-rater reliability was not tested. The study was conducted at one Swedish stroke unit, so performance in other settings and languages is not shown. The FEES protocol could be modified or shortened if the speech-language pathologist judged patient safety risk, so the reference standard was not always the full planned assessment.

The supplied text does not include a funding or conflict-of-interest declaration; the publication types list research support, non-U.S. government.

Do not read the 100% sensitivity for aspiration risk as proof that the Swedish GUSS can replace FEES or rule out swallowing problems in every patient. The study was a single-centre validation with assessments up to 96 hours after onset, mostly mild strokes, and FEES remained the reference standard.