Valid Items for Screening Dysphagia Risk in Patients With Stroke A Systematic Review
Valid Items for Screening Dysphagia Risk in Patients With Stroke A Systematic Review
复制标题
DOI：
10.1161/strokeaha.111.640946
复制
发表时间：
2012-03-01
期刊：
影响因子：
8.3
通讯作者：
Willson, Pamela C.
中科院分区：
文献类型：
--
作者：
Daniels, Stephanie K.;Anderson, Jane A.;Willson, Pamela C.
背景和目的：吞咽困难的筛查对于卒中患者预防性治疗的实施是至关重要的。进行系统评价，以确定吞咽困难筛查项目的循证有效性，使用仪器评估作为参考standard.Methods-Four从1985年到2011年3月的数据库检索使用的术语脑血管疾病，中风吞咽障碍，吞咽困难。合格标准为：同质卒中人群、与仪器检查的比较、无设备的临床检查、吞咽困难或误吸的结局指标以及报告或能够计算的筛选项目的有效性。对符合纳入标准的文章进行了方法学严谨性评价。敏感性，特异性和预测能力计算为each item.Results-Total源文件编号832; 86进行了全面审查，16符合纳入标准。研究质量是可变的。测试吞咽，通常用水，是研究中最常用的项目。吞咽和非吞咽项目均被确定为误吸的预测指标。无论是吞咽协议，也没有有效性是一致的跨studies. Conclusions许多行为被发现与误吸。不吞咽和吞咽项目的最佳组合以及最佳吞咽方案仍不清楚。本综述的结果将有助于开发有效的临床筛查工具。（中风。2012;43：892-897）。
Background and Purpose-Screening for dysphagia is essential to the implementation of preventive therapies for patients with stroke. A systematic review was undertaken to determine the evidence-based validity of dysphagia screening items using instrumental evaluation as the reference standard.Methods-Four databases from 1985 through March 2011 were searched using the terms cerebrovascular disease, stroke deglutition disorders, and dysphagia. Eligibility criteria were: homogeneous stroke population, comparison to instrumental examination, clinical examination without equipment, outcome measures of dysphagia or aspiration, and validity of screening items reported or able to be calculated. Articles meeting inclusion criteria were evaluated for methodological rigor. Sensitivity, specificity, and predictive capabilities were calculated for each item.Results-Total source documents numbered 832; 86 were reviewed in full and 16 met inclusion criteria. Study quality was variable. Testing swallowing, generally with water, was the most commonly administered item across studies. Both swallowing and nonswallowing items were identified as predictive of aspiration. Neither swallowing protocols nor validity were consistent across studies.Conclusions-Numerous behaviors were found to be associated with aspiration. The best combination of nonswallowing and swallowing items as well as the best swallowing protocol remains unclear. Findings of this review will assist in development of valid clinical screening instruments. (Stroke. 2012;43:892-897.)