口腔干燥和唾液腺功能诊断方法的系统评价。
A systematic review of methods to diagnose oral dryness and salivary gland function.
机构信息
Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden.
出版信息
BMC Oral Health. 2012 Aug 8;12:29. doi: 10.1186/1472-6831-12-29.
BACKGROUND
The most advocated clinical method for diagnosing salivary dysfunction is to quantitate unstimulated and stimulated whole saliva (sialometry). Since there is an expected and wide variation in salivary flow rates among individuals, the assessment of dysfunction can be difficult. The aim of this systematic review is to evaluate the quality of the evidence for the efficacy of diagnostic methods used to identify oral dryness.
METHODS
A literature search, with specific indexing terms and a hand search, was conducted for publications that described a method to diagnose oral dryness. The electronic databases of PubMed, Cochrane Library, and Web of Science were used as data sources. Four reviewers selected publications on the basis of predetermined inclusion and exclusion criteria. Data were extracted from the selected publications using a protocol. Original studies were interpreted with the aid of Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool.
RESULTS
The database searches resulted in 224 titles and abstracts. Of these abstracts, 80 publications were judged to meet the inclusion criteria and read in full. A total of 18 original studies were judged relevant and interpreted for this review. In all studies, the results of the test method were compared to those of a reference method.Based on the interpretation (with the aid of the QUADAS tool) it can be reported that the patient selection criteria were not clearly described and the test or reference methods were not described in sufficient detail for it to be reproduced. None of the included studies reported information on uninterpretable/intermediate results nor data on observer or instrument variation. Seven of the studies presented their results as a percentage of correct diagnoses.
CONCLUSIONS
The evidence for the efficacy of clinical methods to assess oral dryness is sparse and it can be stated that improved standards for the reporting of diagnostic accuracy are needed in order to assure the methodological quality of studies. There is need for effective diagnostic criteria and functional tests in order to detect those individuals with oral dryness who may require oral treatment, such as alleviation of discomfort and/or prevention of diseases.
背景
诊断唾液功能障碍最常用的临床方法是定量测量非刺激性和刺激性全唾液（唾液流率）。由于个体之间的唾液流速存在预期的广泛差异，因此功能障碍的评估可能较为困难。本系统评价的目的是评估用于识别口腔干燥的诊断方法的疗效的证据质量。
方法
使用特定索引词和手工搜索进行文献检索，以描述用于诊断口腔干燥的方法的出版物。电子数据库 PubMed、Cochrane 图书馆和 Web of Science 被用作数据源。四名审查员根据预定的纳入和排除标准选择出版物。使用方案从选定的出版物中提取数据。原始研究通过诊断准确性研究质量评估（QUADAS）工具进行解释。
结果
数据库搜索共产生 224 个标题和摘要。其中，有 80 篇摘要被认为符合纳入标准并进行了全文阅读。共有 18 项原始研究被认为相关并进行了此综述的解读。在所有研究中，测试方法的结果均与参考方法的结果进行了比较。根据解释（借助 QUADAS 工具），可以报告说患者选择标准未明确描述，并且测试或参考方法未详细描述，无法进行复制。没有一项纳入的研究报告了无法解释/中间结果的信息，也没有数据报告观察者或仪器的变化。其中 7 项研究将结果表示为正确诊断的百分比。
结论
评估口腔干燥的临床方法的疗效的证据不足，可以说需要改进诊断准确性报告的标准，以确保研究的方法学质量。需要有效的诊断标准和功能测试来检测那些可能需要口腔治疗（如缓解不适和/或预防疾病）的口腔干燥患者。
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