Diagnostic Accuracy of the Modified Evan's Blue Dye Test in Detecting Aspiration in Patients with Tracheostomy: A Systematic Review of the Evidence

被引:26
作者
Bechet, Sibylle [1 ]
Hill, Fiona [2 ]
Gilheaney, Orla [1 ]
Walshe, Margaret [1 ]
机构
[1] Trinity Coll Dublin, Dept Clin Speech & Language Studies, 7-9 South Leinster St, Dublin 2, Ireland
[2] Tallaght Hosp, Dept Speech & Language Therapy, Dublin 22, Ireland
关键词
Deglutition disorders; Oropharyngeal aspiration; Modified Evan's blue dye test; Diagnostic accuracy; Tracheostomy; ENDOSCOPIC EVALUATION; BIAS;
D O I
10.1007/s00455-016-9737-3
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Oropharyngeal aspiration (OPA) is a common occurrence in patients with tracheostomy. The modified Evan's blue dye test (MEBDT) is an easily administered bedside procedure for the assessment of tracheostomised patients. However, studies evaluating the diagnostic accuracy of the MEBDT reach conflicting results. Therefore, we conducted a systematic review to determine the overall accuracy of the MEBDT in detecting OPA in adults with tracheostomy. The search strategy incorporated searching electronic databases, checking reference lists and citations and retrieving unpublished data. Data of primary studies were extracted and examined by three independent reviewers. The assessment of the methodological quality of included studies was performed using the QUADAS-2 tool. Six studies met the inclusion criteria for this systematic review. The studies presented significant disparities in study design and patient characteristics. Furthermore, high discrepancies in the administration of MEBDT across studies were noted. Therefore, a meta-analysis was not considered appropriate. Sensitivity estimates varied widely across the studies (38-95 %), indicating that the MEBDT is unreliable in detecting OPA. However, the studies emerge with overall high specificity values, ranging from 79 to 100 %. This true negative rate suggests that the MEBDT correctly identifies patients without OPA. This review highlights the need for further research studies assessing the accuracy of the MEBDT in detecting aspiration in patients with tracheostomy, using a standardised and reliable procedure. Outcomes from such studies will update the current level of evidence in relation to the MEBDT and consequently define best clinical practice.
引用
收藏
页码:721 / 729
页数:9
相关论文
共 30 条
  • [1] [Anonymous], CAR PAT TRACH BEST P
  • [2] [Anonymous], BRAIN NEUROREHABIL
  • [3] [Anonymous], CLIN CONSISTENCY SPE
  • [4] [Anonymous], REPORTS BLUE DOSCOLO
  • [5] Clinical outcomes for the elderly patient receiving a tracheotomy
    Baskin, JZ
    Panagopoulos, G
    Parks, C
    Rothstein, S
    Komisar, A
    [J]. HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 2004, 26 (01): : 71 - 75
  • [6] Towards complete and accurate reporting of studies of diagnostic accuracy: The STARD initiative
    Bossuyt, PM
    Reitsma, JB
    Bruns, DE
    Gatsonis, CA
    Glasziou, PP
    Irwig, LM
    Lijmer, JG
    Moher, D
    Rennie, D
    de Vet, HCW
    [J]. CLINICAL CHEMISTRY, 2003, 49 (01) : 1 - 6
  • [7] Brady S., 2015, British Journal of Applied Science & Technology, V7, P429
  • [8] The Modified Barium Swallow and the Functional Endoscopic Evaluation of Swallowing
    Brady, Susan
    Donzelli, Joseph
    [J]. OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA, 2013, 46 (06) : 1009 - +
  • [9] de Vet HCW EA, 2008, COCHRANE HDB SYSTEMA
  • [10] Diener HC, 2012, LEITLINIEN DIAGNOSTI, V5th fully reviced