Validity and Reliability of Ultrasound Assessment of Swallowing Function: A Systematic Review and Meta-Analysis.

IF 3.1 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2025-05-02 DOI:10.1111/joor.13992

Yuyu Wang, Qingling Wang, Weixia Yu, Jianzheng Cai, Limi Shan, Xin Wang, Mingjing Fang, Xiaoyan Lu

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引用次数: 0

Abstract

Background: The use of ultrasound (US) makes it convenient to identify dysphagia or swallowing impairment. The aim of the study was to evaluate the validity and reliability of US measurements for swallowing function.

Methods: We conducted a systematic review and meta-analysis. Embase, Medline, Cochrane Library, Web of Science, CINAHL, and Scopus databases were systematically searched from inception to July 22, 2024. Published studies on the validity and reliability of US measurements for assessing dysphagia or swallowing impairment in individuals aged 18 years and older were included. The review followed PRISMA guidelines and was evaluated using the QUADAS-2 tool for diagnostic studies. Two authors independently screened potentially eligible literature, evaluated the quality of the included studies, and then extracted the data. Data synthesis was conducted via random-effects meta-analysis using Stata software.

Results: This review included 38 articles, assessing the value of using hyoid bone displacement, thyrohyoid approximation, and tongue muscle thickness change on US for identifying dysphagia. The pooled sensitivities were 0.64 (95% CI: 0.50-0.79), 0.89 (95% CI: 0.66-1.11), and 0.60 (95% CI: 0.44-0.76), respectively; with pooled specificities of 0.71 (95% CI: 0.64-0.78), 0.82 (95% CI: 0.76-0.88), and 0.69 (95% CI: 0.62-0.77), respectively. Additionally, the area under the summary receiver operating characteristic curve (SROC) for identifying dysphagia using masseter thickness was 0.74 (95% CI: 0.70-0.78). The correlation coefficient of 0.58 (95% CI: 0.20-0.81) was observed between displacement and swallowing function, whereas the correlation for swallowing muscle cross-sectional area (CSA) was 0.26 (95% CI: 0.09-0.42). Meta-analyses revealed intrarater reliability values of 0.88 (95% CI: 0.76-0.94) for displacement, 0.93 (95% CI: 0.87-0.96) for CSA, 0.77 (95% CI: 0.73-0.80) for swallowing muscle thickness, and 0.79 (95% CI: 0.74-0.84) for echo intensity. Interrater reliability values were 0.75 (95% CI: 0.55-0.87) for displacement, 0.89 (95% CI: 0.83-0.94) for CSA, and 0.68 (95% CI: 0.57-0.75) for swallowing muscle thickness.

Conclusion: Data from this review suggested that US was a reliable and valid screening tool for assessing dysphagia and swallowing impairment. Future research could aim at proposing standardised and universal US protocols to promote comparability and reliability in clinical practice.

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超声评估吞咽功能的有效性和可靠性：系统回顾和荟萃分析。

背景：使用超声（US）可以方便地识别吞咽困难或吞咽障碍。本研究的目的是评估美国吞咽功能测量的有效性和可靠性。方法：我们进行了系统综述和荟萃分析。系统检索了Embase、Medline、Cochrane Library、Web of Science、CINAHL和Scopus数据库，检索时间从建站到2024年7月22日。已发表的研究纳入了美国用于评估18岁及以上个体吞咽困难或吞咽障碍的测量方法的有效性和可靠性。该综述遵循PRISMA指南，并使用QUADAS-2诊断研究工具进行评估。两位作者独立筛选可能符合条件的文献，评估纳入研究的质量，然后提取数据。数据综合采用Stata软件进行随机效应meta分析。结果：本综述纳入了38篇文章，评估了使用舌骨移位、甲状腺舌骨近似和舌肌厚度变化在US上识别吞咽困难的价值。合并敏感性分别为0.64 （95% CI: 0.50-0.79）、0.89 （95% CI: 0.66-1.11）和0.60 (95% CI: 0.44-0.76)；合并特异性分别为0.71 （95% CI: 0.64-0.78）、0.82 （95% CI: 0.76-0.88）和0.69 （95% CI: 0.62-0.77）。此外，使用咬肌厚度识别吞咽困难的总受试者工作特征曲线（SROC）下面积为0.74 （95% CI: 0.70-0.78）。位移与吞咽功能的相关系数为0.58 (95% CI: 0.20 ~ 0.81)，吞咽肌横截面积（CSA）的相关系数为0.26 （95% CI: 0.09 ~ 0.42）。meta分析显示，位移的内部信度值为0.88 (95% CI: 0.76-0.94)， CSA的内部信度值为0.93 (95% CI: 0.87-0.96)，吞咽肌厚度的内部信度值为0.77 (95% CI: 0.73-0.80)，回声强度的内部信度值为0.79 （95% CI: 0.74-0.84）。位移的评分可信度值为0.75 (95% CI: 0.55-0.87)， CSA的评分可信度值为0.89 (95% CI: 0.83-0.94)，吞咽肌厚度的评分可信度值为0.68 （95% CI: 0.57-0.75）。结论：本综述的数据表明US是评估吞咽困难和吞咽障碍的可靠有效的筛查工具。未来的研究可能旨在提出标准化和通用的美国方案，以促进临床实践的可比性和可靠性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.