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SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
Volume 15 - 2024 |
doi: 10.3389/fneur.2024.1380287
This article is part of the Research Topic Neurocritical Care and Climate Change View all 5 articles
Advancing Stroke Patient Care: A Network Meta-Analysis of Dysphagia Screening Efficacy and Personalization
Provisionally accepted- 1 Shenzhen Longhua People's Hospital, Shenzhen, China
- 2 Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China
The increasing incidence of stroke globally has led to dysphagia becoming one of the most common complications in stroke patients, with significant impacts on patient outcomes. Accurate early screening for dysphagia is crucial to avoid complications and improve patient quality of life.Included studies involved stroke-diagnosed patients assessed for dysphagia using bedside screening tools. Data was sourced from Embase, PubMed, Web of Science, Scopus, and CINAHL, including publications up to December 10, 2023.The study employed both fixed-effect and random-effects models to analyze sensitivity, specificity, positive predictive value (PPV), and Negative Predictive Value (NPV), each with 95% confidence intervals. The random-effects model was particularly utilized due to observed heterogeneity in study data.Results: From 6,979 records, 21 studies met the inclusion criteria, involving 3,314 participants from 10 countries. The analysis included six assessment tools: GUSS, MASA, V-VST, BSST, WST, and DNTA, compared against gold-standard methods VFSS and FEES. GUSS, MASA, and V-VST showed the highest reliability, with sensitivity and specificity rates of 92% and 85% for GUSS, 89% and 83% for MASA, respectively. Heterogeneity among studies was minimal, and publication bias was low, enhancing the credibility of the findings.Our network meta-analysis underscores the effectiveness of GUSS, MASA, and V-VST in dysphagia screening for stroke patients, with high sensitivity and specificity making them suitable for diverse clinical settings. BSST and WST, with lower diagnostic accuracy, require more selective use. Future research should integrate patient-specific outcomes and standardize methodologies to enhance dysphagia screening tools, ultimately improving patient care and reducing complications.
Keywords: dysphagia, Swallowing disorders, Deglutition, Guss, MASA
Received: 01 Feb 2024; Accepted: 01 Jul 2024.
Copyright: © 2024 Jiang, Chi, Pan, Zhang, Huang, Ju and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Youli Jiang, Shenzhen Longhua People's Hospital, Shenzhen, China
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