SPEECH THERAPY AND REHABILITATION: Edited by H. Fiona Robinson and Jo PattersonThickened liquids: do they still have a place in the dysphagia toolkit?Lazenby-Paterson, TracyAuthor Information NHS Lothian Learning Disability Service, North East Edinburgh CLDT, Leith Community Treatment Centre, Edinburgh, UK Correspondence to Tracy Lazenby-Paterson, NHS Lothian Learning Disability Service, North East Edinburgh CLDT, Leith Community Treatment Centre, 12 Junction Place, Edinburgh EH6 5JA, UK. Tel: +44 0131 536 6256; e-mail: email@example.com Current Opinion in Otolaryngology & Head and Neck Surgery: June 2020 - Volume 28 - Issue 3 - p 145-154 doi: 10.1097/MOO.0000000000000622 Buy Metrics Abstract Purpose of review The use of commercially or naturally thickened liquids is a well-established treatment for patients with dysphagia to fluids, the aim of which is to improve swallow safety by minimizing risk of aspiration. Although the most recent systematic reviews conclude that this treatment lacks evidential support and leads to patient-reported worsening health and quality of life, thickened liquids continue to be used with patients with dysphagia across clinical settings. This review briefly summarizes the evidence and considers potential reasons for the apparent mismatch between the evidence and clinical practice. Recent findings Continuing practice with thickened liquids is influenced by a range of factors, including gaps in clinical knowledge, inadequate patient involvement, a culture of common practice and a reliance on invalid surrogate studies or research lacking a credible association between thickened liquids and clinically meaningful endpoints. Summary While awaiting further research, clinical decision-making about thickened liquids can be improved by considering the evidence of clinically meaningful endpoints, promoting shared decision-making with patients and underpinning practice with knowledge about the complex relationship between dysphagia, aspiration and pneumonia. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.