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Purpose A systematic approach to the diagnosis and treatment of swallowing disorders relies heavily on valid and reliable screening protocols that provide clinicians with clear and objective information. The Yale Swallow Protocol (YSP) has been shown to be a useful, valid, and reliable screening tool for aspiration risk in the acute care setting. However, the YSP was not validated for use in post-acute care. This study evaluated the clinical utility of the YSP in the post-acute care setting. Method This prospective, double-blind, multirater study included a referred sample of 240 individuals, with varying medical diagnoses, who completed the YSP and an endoscopic evaluation of swallowing. Results Sensitivity for the YSP was 95.4%, specificity was 66.9%, positive predictive value was 77.6%, and negative predictive value was 92.4%. Conclusions The data from this prospective study appear to support the use of the YSP in post-acute care due to the ability to use the protocol on virtually all patients—regardless of diagnosis—and its high sensitivity and negative predictive value.

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Conclusions: Using preoperative P2Y12 testing with a threshold of PRU $194 to define CR, we identified a high prevalence of CR in patients undergoing TCAR similar to that in the pre-existing coronary literature. We found no significant differences in postoperative ischemic or hemorrhagic complications by clopidogrel response phenotype, although complication rates in the overall study cohort were low. Further investigation is warranted to determine if a quantitative assessment of CR is sufficient to identify patients at risk of developing secondary cerebrovascular ischemic events in this patient population.