Comparison of two approaches to screen for dysphagia among acute ischemic stroke patients: Nursing admission screening tool versus National Institutes of Health Stroke Scale

Dawn M. Bravata, Virginia S. Daggett, Heather Woodward-Hagg, Teresa Damush, Laurie Plue, Scott Russell, George Allen, Linda S. Williams, Jaroslaw Harezlak, Neale R. Chumbler

Research output: Contribution to journalArticle

18 Scopus citations


This study assessed the positive and negative predictive values and the sensitivity and specificity of a nursing dysphagia screening tool and the National Institutes of Health Stroke Scale (NIHSS) for the identification of dysphagia for veterans hospitalized with ischemic stroke. A secondary objective of this study was to evaluate the speech-language pathology consult rate before and after the nursing admission dysphagia screening tool. This retrospective cohort study evaluated veterans admitted to one Department of Veterans Affairs medical center with ischemic stroke during the 6 months both before and after the implementation of a nursing dysphagia screening tool, which was part of the admission nursing template. Stroke severity was measured with the use of the retrospective NIHSS. Dysphagia diagnosis was based on speech-language pathology evaluations. Dysphagia was present in 38 of 101 patients (38%) with ischemic stroke. The nursing dysphagia screening tool had a positive predictive value of 50% and a negative predictive value of 68%, with a sensitivity of 29% and specificity of 84%. The use of the NIHSS to identify dysphagia risk had a positive predictive value of 60% and a negative predictive value of 84%. The NIHSS had better test characteristics in predicting dysphagia than the nursing dysphagia screening tool. Future research should evaluate the use of the NIHSS as a screening tool for dysphagia.

Original languageEnglish (US)
Pages (from-to)1127-1133
Number of pages7
JournalJournal of Rehabilitation Research and Development
Issue number9
StatePublished - Dec 1 2009



  • Aspiration risk
  • Dysphagia screening
  • Ischemic stroke
  • NIH Stroke Scale
  • Nursing admission
  • Pneumonia prevention
  • Predictive value of tests
  • Sensitivity and specificity
  • Stroke swallowing assessment

ASJC Scopus subject areas

  • Rehabilitation

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