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The report was requested by the Health Care Financing Administration, which sought an evidence-based assessment of methods for diagnosing and treating swallowing disorders (dysphagia) in elderly individuals with neurologic diseases, and specifically those methods associated with the services provided by speech-language pathologists. About 6,228,000 Americans over age 60 have dysphagia, and about 300,000 to 600,000 people are affected by dysphagia resulting from neurologic disorders each year. This report addresses four questions: (1) How does diagnosis of dysphagia or aspiration affect treatment course sand patient outcomes; (2) What are the indications for diagnosing patients using a full bedside exam (BSE), modified barium swallow, fiberoptic endoscopy, or other instrumented exams; (3) Is one diagnostic technology more effective than any other; and (4) When is noninvasive therapy appropriate, and when should feeding tubes be used in certain patient populations.