Health Sciences and Research, Medical University of South Carolina, Charleston.
Academic Affairs Faculty, Medical University of South Carolina, Charleston.
Am J Speech Lang Pathol. 2021 Mar 26;30(2):761-771. doi: 10.1044/2020_AJSLP-20-00255. Epub 2021 Mar 18.
Purpose Despite the emphasis on using evidence-based practice for patient care, as clinicians, we sometimes find that there is insufficient evidence to support our clinical practices. One example of this is the "contentious" inclusion of routine, standardized visualization of the esophagus during modified barium swallow studies (MBSSs). This review sought to investigate the evidence for inclusion of routine esophageal visualization during the MBSS, a practice that is supported by the long-established interrelationship between all aspects of the oral, pharyngeal, and esophageal swallowing continuum. Method Searches were conducted in PubMed, Scopus, and CINAHL databases. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed to identify articles that met prespecified inclusion and exclusion terms. Results Five articles were included in this review, which identified that esophageal findings were present in 48.67% of those participants whose MBSS included esophageal visualization. Conclusion This review supports a standardized, validated, reliable visualization protocol of the esophagus during the MBSS as a critical component to the accurate diagnosis and formulation of treatment recommendations for patients with swallowing disorders.
目的 尽管强调将循证实践用于患者护理,但作为临床医生,我们有时会发现没有足够的证据来支持我们的临床实践。其中一个例子是在改良钡吞咽研究(MBSS)中常规、标准化地可视化食管,这一做法存在争议。本综述旨在研究在 MBSS 中纳入常规食管可视化的证据,该做法得到了口腔、咽和食管吞咽连续体各个方面之间长期存在的相互关系的支持。 方法 在 PubMed、Scopus 和 CINAHL 数据库中进行了检索。按照系统评价和荟萃分析的首选报告项目的指南,确定了符合预先规定的纳入和排除标准的文章。 结果 本综述纳入了 5 篇文章,这些文章发现,在 MBSS 中包括食管可视化的参与者中,有 48.67%存在食管发现。 结论 本综述支持在 MBSS 期间对食管进行标准化、验证、可靠的可视化方案,作为准确诊断和制定吞咽障碍患者治疗建议的关键组成部分。