Audag Nicolas, Goubau Christophe, Toussaint Michel, Reychler Gregory
Service de Médecine Physique, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium.
Unité de Pneumologie Pédiatrique, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Ther Adv Chronic Dis. 2019 Jan 31;10:2040622318821622. doi: 10.1177/2040622318821622. eCollection 2019.
The purpose of this systematic review was to summarize the different dysphagia screening and evaluation tools, and to identify their measurement properties in adults with neuromuscular diseases (NMDs).
A systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search strategy was conducted across three databases ( and ). Measurement properties of each tools and the Quality Index, developed by Downs and Black, were considered for the different investigated studies.
The search strategy produced 2221 articles. After removal of duplicates and full-text analysis, 19 studies were included. Most of the publications focused on amyotrophic lateral sclerosis (ALS; = 10) and Duchenne muscular dystrophy (DMD; = 4). A total of 12 tools, listed as instrumental and noninstrumental examinations, were retrieved. A total of five of them used videofluoroscopic swallow study (VFSS). Measurement properties of the tools are not completely described in detail in many studies. The neuromuscular disease swallowing status scale, a noninstrumental tool, is the only one that assessed all measurement properties in ALS patients. The median score reported for the Quality Index was 16.
This systematic review identified 12 different tools for the screening and evaluation of dysphagia in adults with NMD. Majority of the studies presented VFSS as a valid and reliable examination to assess dysphagia in ALS and DMD. Other tools were mainly evaluated in ALS patients, but further studies are needed to complete their measurement properties. In other NMDs, no firm conclusion can be made because of insufficient data and heterogeneity of NMDs.
本系统评价的目的是总结不同的吞咽困难筛查和评估工具，并确定其在患有神经肌肉疾病（NMD）的成人中的测量特性。
根据系统评价和Meta分析的首选报告项目（PRISMA）指南进行系统评价。检索策略在三个数据库中进行。针对不同的研究，考虑了每种工具的测量特性以及由唐斯和布莱克开发的质量指数。
检索策略产生了2221篇文章。在去除重复项和进行全文分析后，纳入了19项研究。大多数出版物关注肌萎缩侧索硬化症（ALS；n = 10）和杜兴氏肌营养不良症（DMD；n = 4）。总共检索到12种工具，分为仪器检查和非仪器检查。其中共有5种使用了电视荧光吞咽造影检查（VFSS）。许多研究并未详细完整地描述这些工具的测量特性。神经肌肉疾病吞咽状态量表，一种非仪器工具，是唯一在ALS患者中评估了所有测量特性的工具。报告的质量指数中位数为16。
本系统评价确定了12种用于筛查和评估患有NMD的成人吞咽困难的不同工具。大多数研究表明VFSS是评估ALS和DMD患者吞咽困难的有效且可靠的检查方法。其他工具主要在ALS患者中进行了评估，但需要进一步研究以完善其测量特性。在其他NMD中，由于数据不足和NMD的异质性，无法得出确凿结论。
