Developing a Core Outcome Set for oropharyngeal dysphagia screening services in hospitals: a modified Delphi study

Core Outcome Sets (COS) are used by researchers to enable synthesis and comparison of results from trials in similar patient groups and contexts. Around 50% of older adults on care of the older person wards may have Oropharyngeal Dysphagia (OD). Routine OD screening may reduce the risk of mortality and duration of hospital stay. Research is required to identify the effectiveness and cost-effectiveness of an OD screening service. Using a modified Delphi methodology, this study aimed to develop a COS for trials evaluating hospital-based OD screening services. A long list of outcomes, created from a systematic review and similar existing COS, was sent out to nurses, speech and language therapists (SLT), pharmacists, senior hospital staff, researchers, people with OD and carers who rated each outcome’s importance using a Likert scale to help refine this list. A 90-minute online consensus workshop then finalised the COS. 54 outcomes were sent to 34 stakeholders at round one. 25 outcomes were sent to 28 stakeholders at round two.13 stakeholders finalised the COS in the consensus workshop. The final COS consists of; mortality, aspiration pneumonia, choking, medication intake, patients’ experience with the intervention, swallowing-related quality of life, hospitalisation & proportion of patients referred to SLT. This study developed the first COS for evaluating OD screening services in care of the older person hospital wards. Adoption of this COS will facilitate consistency in outcome measurement, evidence synthesis and translation of OD research into clinical practice.