{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:21:40Z","timestamp":1791872500372,"version":"4.3.4"},"reference-count":19,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001665","name":"French National Research Agency","doi-asserted-by":"publisher","award":["ANR-21-CE19-0057-01"],"award-info":[{"award-number":["ANR-21-CE19-0057-01"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>To date, no consensus exists on the complex clinical decision-making processes involved in oropharyngeal dysphagia, or swallowing disorders. This study aimed to develop an international consensus on a clinical decision tree for the disease trajectory of oropharyngeal dysphagia in adults, taking into account physiological impairments of swallowing, risk factors for the development of complications from oropharyngeal dysphagia, and prognostic factors for treatment outcomes. Using the Delphi technique, consensus was achieved among dysphagia experts across 31 countries, resulting in a total of 10 physiological impairments, 23 risk factors and 21 prognostic factors identified as relevant factors in the clinical decision-making process. Factors most contributing to the severity of oropharyngeal dysphagia were \u2018Aspiration\u2019, \u2018Incomplete ejection or failure to eject aspirated materials from the airways\u2019, \u2018Weak or absent cough\u2019, \u2018Choking\u2019 and \u2018Sensory deficits in the oropharynx\u2019. To connect the existing theoretical framework to clinical practice, future research will develop the current findings by corroborating the domains based on relevant factors for clinical decision making and those that contribute to the severity of oropharyngeal dysphagia.<\/jats:p>","DOI":"10.3390\/jcm12206572","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T08:25:09Z","timestamp":1697531109000},"page":"6572","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Expert Consensus on Clinical Decision Making in the Disease Trajectory of Oropharyngeal Dysphagia in Adults: An International Delphi Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2828-8897","authenticated-orcid":false,"given":"Ren\u00e9e","family":"Speyer","sequence":"first","affiliation":[{"name":"Department Special Needs Education, University of Oslo, 0318 Oslo, Norway"},{"name":"Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth 6102, Australia"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1311-4501","authenticated-orcid":false,"given":"Mathieu","family":"Balaguer","sequence":"additional","affiliation":[{"name":"Institut de Recherche en Informatique de Toulouse, Centre national de la Recherche Scientifique, University of Toulouse, 31062 Toulouse, France"},{"name":"Department of Medicine, Maieutic and Allied Health, Faculty of Health, University of Toulouse, Paul Sabatier Toulouse III, 133 Route de Narbonne, 31062 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle","family":"Cugy","sequence":"additional","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine, Arcachon Hospital, 33260 La Teste de Buch, France"},{"name":"Department of Physical and Rehabilitation Medicine, Tastet Girard Hospital, CEDEX, 33076 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8220-0419","authenticated-orcid":false,"given":"Cl\u00e9mence","family":"Devoucoux","sequence":"additional","affiliation":[{"name":"Department of Medicine, Maieutic and Allied Health, Faculty of Health, University of Toulouse, Paul Sabatier Toulouse III, 133 Route de Narbonne, 31062 Toulouse, France"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Larrey Hospital, University Hospital of Toulouse, 31400 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5884-7285","authenticated-orcid":false,"given":"Sylvain","family":"Morini\u00e8re","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Tours University Hospital, 37000 Tours, France"},{"name":"Otorhinolarygology Department, University Fran\u00e7ois Rabelais of Tours, 10 Bd Tonnell\u00e9, 37032 Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ga\u00eblle","family":"Soriano","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Toulouse University Hospital, 31000 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"V\u00e9rin","sequence":"additional","affiliation":[{"name":"GRHVN UR 3830, Research Group on Ventilatory and Neurological Handicap, Laboratoire de Chirurgie Experimentale, University of Rouen Normandie, 76000 Rouen, France"},{"name":"Department of Pulmonary Rehabilitation, CHU Rouen, UR 3830, Normandie University, UNIROUEN, 76000 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Woisard","sequence":"additional","affiliation":[{"name":"Department of Medicine, Maieutic and Allied Health, Faculty of Health, University of Toulouse, Paul Sabatier Toulouse III, 133 Route de Narbonne, 31062 Toulouse, France"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Larrey Hospital, University Hospital of Toulouse, 31400 Toulouse, France"},{"name":"Neuro-Psycho-Linguistic Lab UR 4156, University of Toulouse, Jean Jaur\u00e8s Toulouse II, 5, All\u00e9e Antonio Machado, CEDEX 9, 31058 Toulouse, France"},{"name":"Department of Supportive Care, Cancer University Institute of Toulouse Oncopole, 1 avenue Ir\u00e8ne Joliot-Curie, CEDEX 9, 31059 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Speyer, R., Cordier, R., Denman, D., Windsor, C., Krisciunas, G.P., Smithard, D., and Heijnen, B.J. 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