Clinical efficacy and randomized clinical trials in dysphagia

This manuscript reviews the current state of research on treatment efficacy for swallowing disorders in relation to the use of large-scale randomized multi institutional trials. Dose response trials, i.e., how much treatment is needed to achieve the desired result, are not yet available in dysphagia. The financial and medical pressures on clinicians responsible for diagnosing and treating the dysphagic patient are noted as they often impact the timing of patient care in dysphagia. The process of integration of treatment techniques into the diagnostic study (Modified Barium Swallow, videofluoroscopy) to improve the patient's swallow as quickly as possible is described. The availability of a clinical trial group, the Communications Sciences and Disorders Clinical Trials Research Group (CSDRG), is noted to assist clinicians and scientists in the development of all types of clinical trials in dysphagia.