Cichero J, Clavé P (eds): Stepping Stones to Living Well with Dysphagia. Nestlé Nutr Inst Workshop Ser, vol 72, pp 33–42, Nestec Ltd., Vevey/S. Karger AG., Basel, © 2012 The Volume-Viscosity Swallow Test for Clinical Screening of Dysphagia and Aspiration Laia Rofes a  Viridiana Arreola b  Pere Clavé a,b a Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, b Unitat d’Exploracions Funcionals Digestives, Hospital de Mataró, Barcelona, Spain Abstract Background: Oropharyngeal dysphagia (OD) is a major complaint among many patients with neurological diseases and in the elderly, but is often underdiagnosed. The volume- viscosity swallow test (V-VST) is a bedside method to screen patients for dysphagia. Methods: The V-VST was designed to identify clinical signs of impaired efficacy (labial seal, oral and pharyngeal residue, and piecemeal deglutition) and impaired safety of swal- low (voice changes, cough and decrease in oxygen saturation ≥3%). It starts with nectar viscosity and increasing bolus volume, then liquid and finally pudding viscosity in a pro- gression of increasing difficulty to protect patients from aspiration. Results: The V-VST allows quick, safe and accurate screening for OD in hospitalized and independently living patients with multiple etiologies. The V-VST presents a sensitivity of 88.2% and a specific- ity of 64.7% to detect clinical signs of impaired safety of swallow (aspiration or penetra- tion). The test takes 5–10 min to complete. Discussion and Conclusion: The V-VST is an excellent tool to screen patients for OD. It combines good psychometric properties, a detailed and easy protocol designed to protect safety of patients, and valid end points to evaluate safety and efficacy of swallowing and detect silent aspirations. Copyright © 2012 Nestec Ltd., Vevey/S. Karger AG, Basel Introduction Oropharyngeal dysphagia (OD) is a major complaint among many patients with neurological diseases and in the elderly, but is not always systematically explored and detected. OD is specifically classified by the World Health Organization in the International Statistical Classification of Diseases and Related Health Problems ICD-9 and ICD-10 (787.2, R13) [1]. Although sufferers are sometimes Detection