1.1 Current evidence on the efficacy of transcutaneous neuromuscular electrical stimulation (NMES) for oropharyngeal dysphagia is limited in quality. The evidence on safety is limited in both quality and quantity but there were no major safety concerns. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
1.2 Clinicians wishing to undertake transcutaneous NMES for oropharyngeal dysphagia should take the following actions.
Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
1.3 NICE encourages further research into transcutaneous NMES for oropharyngeal dysphagia, which should clearly document the indications for treatment and the details of patient selection. Research should document the timing of initiation of treatment after onset of symptoms, as well as precise information about the procedure technique. Outcome measures should include freedom from tube feeding, quality of life and duration of treatment effect. NICE may review the procedure on publication of further evidence.