TY - JOUR
T1 - Diagnostic accuracy of ultrasound examination in detecting aspiration and pharyngeal residue in patients with dysphagia
T2 - A systematic review and meta-analysis
AU - Miura, Yuka
AU - Tamai, Nao
AU - Kitamura, Aya
AU - Yoshida, Mikako
AU - Takahashi, Toshiaki
AU - Mugita, Yuko
AU - Tobita, Itoko
AU - Arita, Mikiko
AU - Urai, Tamae
AU - Dai, Misako
AU - Noguchi, Hiroshi
AU - Matsumoto, Masaru
AU - Mukai, Kanae
AU - Nakagami, Gojiro
AU - Ota, Erika
AU - Sugama, Junko
AU - Sanada, Hiromi
N1 - Publisher Copyright:
© 2020 Japan Academy of Nursing Science
PY - 2021/4
Y1 - 2021/4
N2 - Aim: To estimate diagnostic accuracy of ultrasonography for detecting aspiration and pharyngeal residue in patients with dysphagia. Methods: A systematic search was conducted in MEDLINE (via PubMed), CINAHL, EMBASE, Ichushi-Web, and Cochrane Library databases to identify articles that showed diagnostic accuracy of ultrasonography for detecting aspiration and residue published in English and Japanese until August 2019. Cross-sectional studies, case–control studies, and cohort studies were included. The diagnostic accuracy results were extracted and the pooled estimated sensitivity and specificity were calculated. The risk of bias of the studies was assessed using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies 2. The certainty of the evidence was assessed using the Grades of Recommendation Assessment, Development, and Evaluation methodology. Results: Five studies were included in this review. The pooled estimated sensitivity and specificity for detecting aspiration were 0.82 (95% CI: 0.72–0.89) and 0.87 (95% CI: 0.81–0.92), respectively. One study was included that evaluated ultrasound assessments of pharyngeal residue. The sensitivity and specificity were 0.62 (95% CI: 0.32–0.86) and 0.67 (95% CI: 0.22–0.96), respectively. The certainty of the evidence was low and very low for the diagnostic accuracy of aspiration and pharyngeal residue, respectively. Conclusion: Ultrasound is a non-invasive method with good sensitivity and specificity in detecting aspiration as well as reference standards. While risk of bias and small number of studies limited the strength of this systematic review, our results suggested that ultrasound examination was useful as a bedside screening tool for detecting aspiration.
AB - Aim: To estimate diagnostic accuracy of ultrasonography for detecting aspiration and pharyngeal residue in patients with dysphagia. Methods: A systematic search was conducted in MEDLINE (via PubMed), CINAHL, EMBASE, Ichushi-Web, and Cochrane Library databases to identify articles that showed diagnostic accuracy of ultrasonography for detecting aspiration and residue published in English and Japanese until August 2019. Cross-sectional studies, case–control studies, and cohort studies were included. The diagnostic accuracy results were extracted and the pooled estimated sensitivity and specificity were calculated. The risk of bias of the studies was assessed using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies 2. The certainty of the evidence was assessed using the Grades of Recommendation Assessment, Development, and Evaluation methodology. Results: Five studies were included in this review. The pooled estimated sensitivity and specificity for detecting aspiration were 0.82 (95% CI: 0.72–0.89) and 0.87 (95% CI: 0.81–0.92), respectively. One study was included that evaluated ultrasound assessments of pharyngeal residue. The sensitivity and specificity were 0.62 (95% CI: 0.32–0.86) and 0.67 (95% CI: 0.22–0.96), respectively. The certainty of the evidence was low and very low for the diagnostic accuracy of aspiration and pharyngeal residue, respectively. Conclusion: Ultrasound is a non-invasive method with good sensitivity and specificity in detecting aspiration as well as reference standards. While risk of bias and small number of studies limited the strength of this systematic review, our results suggested that ultrasound examination was useful as a bedside screening tool for detecting aspiration.
KW - aspiration pneumonia
KW - sensitivity and specificity
KW - swallowing
KW - systematic review and meta-analysis
KW - ultrasonography
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U2 - 10.1111/jjns.12396
DO - 10.1111/jjns.12396
M3 - Review article
C2 - 33843140
AN - SCOPUS:85104102424
SN - 1742-7932
VL - 18
JO - Japan Journal of Nursing Science
JF - Japan Journal of Nursing Science
IS - 2
M1 - e12396
ER -