Limitations
A key limitation is the sample size. The current study only represents one hospital trust and SLT team in the UK, therefore it may not reflect practice within the wider SLT community. Evidence suggests that oral trials are being used globally with FOIS outcome measures being developed in the United States 9, documented use in Australia 12 and mention of oral trials in conference abstracts from Ireland 13 and India15. This suggests that a larger study, looking at how oral trials are delivered nationally and internationally, is indicated.
Data collection did not consider the wider context of an individual’s health status. The study did not have access to the original medical notes and due to the absence of standardised assessments on the electronic patient record, cognitive ability, frailty measures or extent of co-morbidities were not recorded. As demonstrated in statistical analysis, although the model explains some of the variance, there are likely other factors contributing to outcomes. Therefore, other aspects affecting clinical decision making may have been overlooked.
Due to the nature of quantitative data, results are unlikely to reflect the complexity of clinical reasoning when managing oral trials. Further research is therefore required to investigate the clinical decision-making process. Moreover, although results begin to illustrate the ways in which oral trials are used, they do not evidence their effectiveness. SLT practice should use the highest level evidence to support practice 8 and given the scarcity of research in this field, randomised control trials are warranted.