Abstract Body:
Introduction
Dysphagia (swallowing difficulties) is common post stroke and an independent predictor of poor outcome, but there are no standardised treatment guidelines. Pharyngeal electrical stimulation (PES) is licensed for use in the UK and Europe but lacks a definitive evidence-base and so is not widely used. We aim to assess whether PES is safe and effective at improving post-stroke dysphagia.

Methods
PhEAST is an international prospective, randomised, open-label, blinded-endpoint (PROBE) trial. 800 adults with recent (2-31 days) ischaemic or haemorrhagic anterior or posterior circulation stroke, and clinical dysphagia with a reliance on non-oral nutrition will be recruited.
Patients will be randomised (1:1), with minimisation on country, age, sex, dysphagia severity rating scale (DSRS), impairment, stroke type, circulation and time to randomisation, to receive either PES or No PES. The PES group will receive six, once daily (10 minute) treatments of PES. Both groups will receive standard dysphagia rehabilitation.
The primary outcome is dysphagia status, assessed using the Dysphagia Severity Rating Scale (DSRS) at day 14. Secondary outcomes include PES threshold and tolerability at day 7, dysphagia status, dependency, disability, quality of life, cognition, mood and disposition at 90 and all-cause mortality at day 365.

Results
As of 17^th October 2024, 273 participants have been recruited to the PhEAST trial.

Conclusions
PhEAST will provide definitive evidence for the use of PES in acute stroke. The results may directly inform clinical decision making and support decisions on guidelines for standardised practice in dysphagia treatment.