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.