Chen Po-Cheng, Chuang Ching-Hui, Leong Chau-Peng, Guo Su-Er, Hsin Yi-Jung
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
College of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Taiwan.
J Adv Nurs. 2016 Nov;72(11):2575-2586. doi: 10.1111/jan.13013. Epub 2016 May 29.
The aim of this study was to determine the diagnostic accuracy of the water swallow test for screening aspirations in stroke patients.
The water swallow test is a simple bedside screening tool for aspiration among stroke patients in nursing practice, but results from different studies have not been combined before.
A systematic review and meta-analysis was conducted to provide a synthetic and critical appraisal of the included studies.
Electronic literature in MEDLINE, EMBASE, CINAHL and other sources were searched systemically in this study. Databases and registers were searched from inception up to 30 April 2015.
This systematic review was conducted using the recommendations from Cochrane Collaboration for Systematic Reviews of Diagnostic Test Accuracy. Bivariate random-effects models were used to estimate the diagnostic accuracy across those studies. The tool named Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used to evaluate the quality of the studies.
There were 770 stroke patients in the 11 studies for the meta-analysis. The water swallow test had sensitivities between 64-79% and specificities between 61-81%. Meta-regression analysis indicated that increasing water volume resulted in higher sensitivity but lower specificity of the water swallow test.
This systematic review showed that the water swallow test was a useful screening tool for aspiration among stroke patients. The test accuracy was related to the water volume and a 3-oz water swallow test was recommended for aspiration screening in stroke patients.
本研究旨在确定水吞咽试验对筛查脑卒中患者误吸的诊断准确性。
水吞咽试验是护理实践中用于筛查脑卒中患者误吸的一种简单的床边筛查工具，但此前不同研究的结果尚未合并。
进行了一项系统评价和荟萃分析，以对纳入的研究进行综合和批判性评价。
本研究系统检索了MEDLINE、EMBASE、CINAHL及其他来源的电子文献。检索数据库和登记库的时间范围从建库至2015年4月30日。
本系统评价按照Cochrane协作网关于诊断试验准确性系统评价的推荐意见进行。使用双变量随机效应模型估计这些研究的诊断准确性。采用诊断准确性研究质量评估工具（QUADAS-2）评估研究质量。
纳入荟萃分析的11项研究中有770例脑卒中患者。水吞咽试验的敏感性在64%至79%之间，特异性在61%至81%之间。Meta回归分析表明，增加饮水量会导致水吞咽试验的敏感性升高，但特异性降低。
本系统评价表明，水吞咽试验是筛查脑卒中患者误吸的一种有用的筛查工具。试验准确性与饮水量有关，推荐采用3盎司水吞咽试验筛查脑卒中患者的误吸情况。
