Clinical feeding examination with cervical auscultation for detecting oropharyngeal aspiration: A systematic review of the evidence

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Frakking, TT
Chang, AB
David, M
Orbell-Smith, J
Weir, KA
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2019
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Abstract

Background: Cervical auscultation (i.e. listening to swallowing sounds) is the most commonly used technique in adjuvant to the clinical feeding examination by speech-language pathologists worldwide to assess for oropharyngeal aspiration risk in children. Despite its relative popularity in clinical practice, little is known on the clinical utility of cervical auscultation within a paediatric population. Objective: To determine the diagnostic test accuracy of the clinical feeding examination with cervical auscultation in the detection of aspiration in children. Type of review: Narrative review. Prospero Registration: CRD42017081467 Search strategy: Medline/Pub Med, Embase, CINAHL, AustHealth, Cochrane and UQ (Scopus) were searched up until October 2017. Specifically, the search terms used were: (((oropharyngeal OR respiratory) aspiration) AND (child* OR pediatr* OR paediatr*) and (cervical auscultation OR swallow sounds OR swallowing sounds OR accelerometry OR swallowing acoustics)). The search strategy also included scanning reference lists and citations of retrieved studies. Evaluation method: Extracted studies were reviewed by two independent reviewers. Methodological quality of studies was assessed using the QUADAS-2 tool. Results: Only one study met inclusion criteria for this review, which had a bias for flow and timing. Use of cervical auscultation in conjunction with the clinical feeding examination to predict aspiration had a positive predictor value (PPV) of only 0.49 (0.31-0.66), indicating potential over-prediction of aspiration when cervical auscultation is used. In contrast a high NPV of 0.92 (0.78-0.98) was reported indicating that cervical auscultation is useful at ruling out aspiration in children. Conclusion: This review highlights the paucity of research studies assessing the accuracy of cervical auscultation as an adjuvant to the clinical feeding examination in aspiration detection within the paediatric population.

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Clinical Otolaryngology

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44

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6

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Allied health and rehabilitation science

Speech pathology

Paediatrics

Respiratory diseases

cervical auscultation

child

deglutition

deglutition disorders

oropharyngeal aspiration

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Frakking, TT; Chang, AB; David, M; Orbell-Smith, J; Weir, KA, Clinical feeding examination with cervical auscultation for detecting oropharyngeal aspiration: A systematic review of the evidence, Clinical Otolaryngology, 2019, 44 (6), pp. 927-934

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