Early detection of oropharyngeal dysphagia in rehabilitation and long-term care sectors: the EDOR-Care cross-sectional study protocol.

INTRODUCTION: Oropharyngeal dysphagia (OD), or difficulty swallowing, is a common yet frequently underdiagnosed condition that can lead to serious complications, reduced quality of life and increased healthcare costs. Early identification of at-risk patients is therefore essential. Although screening tools such as the Volume-Viscosity Swallow Test (V-VST) are widely used, they remain time-consuming, require trained staff and are often validated only in specific populations (eg, patients who had a post-stroke). This study aims first to establish the prevalence of OD risk in rehabilitation and long-term care units; second, to quantify the agreement between bedside nurses and specially trained nurses using the same institutional screening tools; and third, to estimate the criterion validity of two institutional tools less time-consuming and easier to use against the V-VST, used as the comparator standard. Clinical risk factors and patient characteristics associated with OD will be identified to develop a simple, rapid and reliable predictive risk score. Designed for use by non-specialised staff at admission, this tool should support early detection and optimise resource allocation across diverse care settings.

METHODS AND ANALYSIS: This cross-sectional study will screen for OD all adult inpatients admitted to rehabilitation units and long-term care sectors of the Departments of Clinical Neurosciences and Rehabilitation & Geriatrics, that is, an expected total of 457-487 patients recruited consecutively and exhaustively without random sampling. The primary outcome is the prevalence of OD, which will be compared with published estimates. Secondary outcomes will include identifying risk factors and clinical characteristics, assessing the agreement between bedside nurses and specially trained nurses, validating two institutional screening tools against the V-VST and developing a predictive risk score for early detection at admission. Analyses will comprise proportions with 95% CIs, multivariable logistic regression, percentage agreement and Cohen's kappa, sensitivity, specificity, predictive values and likelihood ratios, and development of a points-based risk score with internal validation by bootstrapping.

ETHICS AND DISSEMINATION: The study has received ethics committee approval (2025-00401). This manuscript reports the study protocol: at the time of submission, no participant had been screened, and no data had been collected. Inclusions are planned from 4 January 2027 to 30 June 2027. Findings will be disseminated through peer-reviewed scientific journals and conferences. If internally validated, the predictive score could inform early identification of patients at risk of OD within the study institution; any broader clinical use would require independent external validation and compliance with the applicable medical device regulations.