背景:口咽吞咽困难是神经科患者中一种非常普遍的合并症,对健康构成严重威胁,这可能导致吸入性肺炎的结果,从住院到死亡。这项评估提出了一种非侵入性,基于声学的方法来区分有和没有穿透和抽吸信号的个体。
目的:本系统评价评估吞咽声音的不同方法的诊断有效性,与视频荧光镜吞咽研究相比,检测口咽吞咽困难。
方法:在没有语言或时间限制的五个电子数据库中搜索了主要目的是评估吞咽声音的准确性的文章。在ReviewManagerv.5.2(TheNordicCochraneCentre,哥本哈根,丹麦)。使用诊断准确性研究质量评估工具-2对所选研究的方法进行评估。
结果:最终的电子搜索显示了554条记录,然而,只有3项研究符合纳入标准.麦克风的准确度值(曲线下面积)为0.94,0.80的多普勒,听诊器为0.60。
结论:基于有限的证据和较低的方法学质量,因为纳入的研究很少,样本量很小,从本次系统评价发现的所有索引测试中,多普勒对吞咽声音的辨别显示出极好的诊断准确性,而麦克风报告的对吞咽困难患者吞咽声音的良好辨别准确性和听诊器显示最佳筛查测试。
BACKGROUND: Oropharyngeal dysphagia is a highly prevalent comorbidity in neurological patients and presents a serious health threat, which may lead to outcomes of aspiration pneumonia, ranging from hospitalization to death. This assessment proposes a non-invasive, acoustic-based method to differentiate between individuals with and without signals of penetration and aspiration.
OBJECTIVE: This systematic review evaluated the diagnostic validity of different methods for assessment of swallowing sounds, when compared to videofluroscopy swallowing study to detect oropharyngeal dysphagia.
METHODS: Articles in which the primary objective was to evaluate the accuracy of swallowing sounds were searched in five electronic databases with no language or time limitations. Accuracy measurements described in the studies were transformed to construct receiver operating characteristic curves and forest plots with the aid of Review Manager v. 5.2 (The Nordic Cochrane Centre, Copenhagen, Denmark). The methodology of the selected studies was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies-2.
RESULTS: The final electronic search revealed 554 records, however only 3 studies met the inclusion criteria. The accuracy values (area under the curve) were 0.94 for microphone, 0.80 for doppler, and 0.60 for stethoscope.
CONCLUSIONS: Based on limited evidence and low methodological quality because few studies were included, with a small sample size, from all index testes found for this systematic review, doppler showed excellent diagnostic accuracy for the discrimination of swallowing sounds, whereas microphone-reported good accuracy discrimination of swallowing sounds of dysphagic patients and stethoscope showed best screening test.