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Diagnostic accuracy of the clinical feeding evaluation in detecting aspiration in children: a systematic review
Author(s) -
Calvo Irene,
Conway Aifric,
Henriques Filipa,
Walshe Margaret
Publication year - 2016
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13058
Subject(s) - diagnostic accuracy , swallowing , medicine , clinical practice , dysphagia , diagnostic test , medline , systematic review , pediatrics , medical physics , physical therapy , radiology , biology , biochemistry
The aim of this systematic review is to determine the diagnostic accuracy of clinical feeding evaluation ( CFE ) compared to instrumental assessments in detecting oropharyngeal aspiration ( OPA ) in children. This is important to support clinical decision‐making and to provide safe, cost‐effective, higher quality care. All published and unpublished studies in all languages assessing the diagnostic accuracy of CFE compared to videofluoroscopic swallowing study ( VFSS ) and/or fibre‐optic endoscopic examination of swallowing ( FEES ) in detecting OPA in paediatric populations were sought. Databases were searched from inception to April 2015. Grey literature, citations, and references were also searched. Two independent reviewers extracted and analysed data. Accuracy estimates were calculated. Research reports were translated into English as required. Six studies examining the diagnostic accuracy of CFE using VFSS and/or FEES were eligible for inclusion. Sample sizes, populations studied, and CFE characteristics varied widely. The overall methodological quality of the studies, assessed with QUADAS ‐2, was considered ‘low’. Results suggested that CFE s trialling liquid consistencies might provide better accuracy estimates than CFE s trialling solids exclusively. This systematic review highlights the critical lack of evidence on the accuracy of CFE in detecting OPA in children. Larger well‐designed primary diagnostic test accuracy studies in this area are needed to inform dysphagia assessment in paediatrics.