■全球范围内中风的发病率不断上升,导致吞咽困难成为中风患者最常见的并发症之一,对患者预后有重大影响。准确的早期筛查吞咽困难对于避免并发症和提高患者生活质量至关重要。
■纳入的研究涉及卒中诊断患者使用床边筛查工具评估吞咽困难。数据来自Embase,PubMed,WebofScience,Scopus,和CINAHL,包括截至2023年12月10日的出版物。这项研究采用了固定效应和随机效应模型来分析敏感性,特异性,阳性预测值(PPV),和负预测值(NPV),每个都有95%的置信区间。由于在研究数据中观察到的异质性,特别使用了随机效应模型。
■从6,979条记录中,21项研究符合纳入标准,涉及来自10个国家的3,314名参与者。分析包括六个评估工具:GUSS,马萨,V-VST,BSST,WST,还有DNTA,与黄金标准方法VFSS和费用进行比较。GUSS,马萨,V-VST表现出最高的可靠性,GUSS的敏感性和特异性分别为92%和85%,89%和83%的MASA,分别。研究之间的异质性很小,出版偏倚很低,提高调查结果的可信度。
■我们的网络荟萃分析强调了GUSS的有效性,马萨,和V-VST在中风患者吞咽困难筛查中的应用,具有高灵敏度和特异性,使其适用于不同的临床设置。BSST和WST,诊断准确性较低,需要更多的选择性使用。未来的研究应该整合患者特定的结果和标准化的方法,以增强吞咽困难的筛查工具。最终改善患者护理并减少并发症。
■https://www.crd.约克。AC.uk/PROSPERO/#recordDetails.
UNASSIGNED: The increasing incidence of stroke globally has led to dysphagia becoming one of the most common complications in stroke patients, with significant impacts on patient outcomes. Accurate early screening for dysphagia is crucial to avoid complications and improve patient quality of life.
UNASSIGNED: Included studies involved stroke-diagnosed patients assessed for dysphagia using bedside screening tools. Data was sourced from Embase, PubMed, Web of Science, Scopus, and CINAHL, including publications up to 10 December 2023. The study employed both fixed-effect and random-effects models to analyze sensitivity, specificity, positive predictive value (PPV), and Negative Predictive Value (NPV), each with 95% confidence intervals. The random-effects model was particularly utilized due to observed heterogeneity in study data.
UNASSIGNED: From 6,979 records, 21 studies met the inclusion criteria, involving 3,314 participants from 10 countries. The analysis included six assessment tools: GUSS, MASA, V-VST, BSST, WST, and DNTA, compared against gold-standard methods VFSS and FEES. GUSS, MASA, and V-VST showed the highest reliability, with sensitivity and specificity rates of 92% and 85% for GUSS, 89% and 83% for MASA, respectively. Heterogeneity among studies was minimal, and publication bias was low, enhancing the credibility of the findings.
UNASSIGNED: Our network meta-analysis underscores the effectiveness of GUSS, MASA, and V-VST in dysphagia screening for stroke patients, with high sensitivity and specificity making them suitable for diverse clinical settings. BSST and WST, with lower diagnostic accuracy, require more selective use. Future research should integrate patient-specific outcomes and standardize methodologies to enhance dysphagia screening tools, ultimately improving patient care and reducing complications.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/#recordDetails.