Diagnostic accuracy of screening tools for silent aspiration in patients with dysphagia: a systematic review and meta-analysis

作者：Wenjing Sun, Wenyao Cui, Yi Jiang, Wenjie Liu · 发表于：Frontiers in Neurology · 年份：2025 · DOI：10.3389/fneur.2025.1576869 · 被引用次数：7 · 研究领域：Dysphagia Assessment and Management、Child Nutrition and Feeding Issues、Gastroesophageal reflux and treatments

Background: The diagnosis and screening of silent aspiration are crucial for patients with dysphagia. This study aimed to synthesize the evidence and evaluate the diagnostic accuracy of screening tools for silent aspiration in patients with dysphagia. Methods: A comprehensive search of 6 databases including Pubmed, Web of Science, CINAHL, Cochrane Library, Scopus, and Embase was conducted from database inception to July 1st, 2024. Meta-analysis was performed on more than three studies. The bivariate mixed effect model was used to pool the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Narrative analysis was applied for studies that could not conduct meta-analysis. Results: A total of nine studies were identified, which included six screening tools. Five of these screening tools for silent aspiration were analyzed descriptively. The meta-analysis was conducted to calculate the diagnostic accuracy of cough reflex test (CRT). The combined sensitivity and specificity of CRT were 0.65 (95% CI: 0.38-0.85) and 0.71 (95% CI: 0.63-0.79), respectively. The PLR, NLR, and DOR were 2.27 (95% CI: 1.49-3.47), 0.49 (95% CI: 0.24-0.99), and 4.68 (95% CI: 1.57-13.98), respectively. The area under the SROC curve was 0.73 (95% CI: 0.69-0.77). Conclusion: The videofluoroscopic swallowing study (VFSS) and flexible endoscopic evaluation of swallowing (FEES) remain the widely used gold standards for diagnosing silent aspir...