Evidence map›Paper›PMID 27102184›Full record

SynthesisChest2016

Screening Accuracy for Aspiration Using Bedside Water Swallow Tests: A Systematic Review and Meta-Analysis.

Martin B Brodsky, Debra M Suiter, Marlís González-Fernández, Henry J Michtalik, Tobi B Frymark, Rebecca Venediktov, Tracy Schooling

Open access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Chest, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 7 pooled it
22.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 7 syntheses or guidelines pooled it, 192 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Screening for aspiration risk associated with dysphagia in acute stroke.The Cochrane database of systematic reviews · 2021
    Pooled it
  4. Pooled it
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  7. Presentation of oropharyngeal dysphagia and rehabilitative intervention following esophagectomy: a systematic review.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2018
    Pooled it
  8. Assessment of the role and effectiveness of nurse-led multimodal intervention in the rehabilitation of dysphagia in patients with brain tumors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Trial
  9. Volume-viscosity swallow test to facilitate individualized dietary modifications for dysphagia following intracerebral hemorrhage.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Trial
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  13. Observational
  14. Article
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  19. Diagnostic accuracy of the gugging swallowing screen (GUSS) in detecting aspiration and dysphagia in patients with unilateral vocal fold paralysis.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Article
  20. Article

18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Martin B BrodskyDepartment of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD; Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD. Electronic address: brodsky@jhmi.edu.
Debra M SuiterCollege of Health Sciences, Division of Communication Sciences and Disorders, University of Kentucky, Lexington, KY.
Marlís González-FernándezDepartment of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD.
Henry J MichtalikDepartment of Medicine, Division of General Internal Medicine, Hospitalist Program, Johns Hopkins University, Baltimore, MD; Armstrong Institute for Patient Safety and Quality, Johns Hopkins University, Baltimore, MD.
Tobi B FrymarkNational Center for Evidence-Based Practice in Communication Disorders, American Speech-Language-Hearing Association, Rockville, MD.
Rebecca VenediktovNational Center for Evidence-Based Practice in Communication Disorders, American Speech-Language-Hearing Association, Rockville, MD.
Tracy SchoolingNational Center for Evidence-Based Practice in Communication Disorders, American Speech-Language-Hearing Association, Rockville, MD.
American Speech Language Hearing Association · USJohns Hopkins University · USNational Patient Safety Foundation · USUniversity of Kentucky · US

Funding

Neural Basis of Coexisting Swallowing and Communication Disorders after StrokeK23DC011056 · NIDCD · JOHNS HOPKINS UNIVERSITY · PI GONZALEZ-FERNANDEZ, MARLIS · 2013 to 2017
$1.2M
Understanding and Improving Dysphagia after Mechanical VentilationK23DC013569 · NIDCD · JOHNS HOPKINS UNIVERSITY · PI BRODSKY, MARTIN BRUCE · 2014 to 2017
$836k
Studying Attending Physician Workload and Improving Patient Safety and OutcomesK08HS022331 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI MICHTALIK, HENRY JOSEPH · 2014 to 2016
$471k
AHRQ HHS K08 HS022331NIDCD NIH HHS K23 DC011056NIDCD NIH HHS K23 DC013569
6 · The paper itself

Abstract

backgroundHospitalizations for aspiration pneumonia have doubled among older adults. Using a bedside water swallow test (WST) to screen for swallowing-related aspiration can be efficient and cost-effective for preventing additional comorbidities and mortality. We evaluated screening accuracy of bedside WSTs used to identify patients at risk for dysphagia-associated aspiration.

methodsSixteen online databases, Google Scholar, and known content experts through May 2015 were searched. Only prospective studies with patients ≥ 18 years of age given WST screenings validated against nasoendoscopy or videofluoroscopy were included. Data extraction used dual masked extraction and quality assessment following Meta-analysis of Observational Studies in Epidemiology guidelines.

resultsAirway response (eg, coughing/choking) with or without voice changes (eg, wet/gurgly voice quality) was used to identify aspiration during three different bedside WSTs. Pooled estimates for single sip volumes (1-5 mL) were 71% sensitive (95% CI, 63%-78%) and 90% specific (95% CI, 86%-93%). Consecutive sips of 90 to 100 mL trials were 91% sensitive (95% CI, 89%-93%) and 53% specific (95% CI, 51%-55%). Trials of progressively increasing volumes of water were 86% sensitive (95% CI, 76%-93%) and 65% specific (95% CI, 57%-73%). Airway response with voice change improved overall accuracy in identifying aspiration.

conclusionsCurrently used bedside WSTs offer sufficient, although not ideal, utility in screening for aspiration. Consecutive sips with large volumes in patients who did not present with overt airway responses or voice changes appropriately ruled out risk of aspiration. Small volumes with single sips appropriately ruled in aspiration when clinical signs were present. Combining these bedside approaches may offer improved screening accuracy, but further research is warranted.

Indexed as

Point-of-Care TestingAdultDeglutition DisordersEndoscopyHumansMass ScreeningPhotofluorographyPneumonia, AspirationRespiratory AspirationSensitivity and Specificityaspirationdysphagiapneumoniareviewscreening

Identifiers

PMID27102184
PMCPMC4980548
OpenAlexW2341823158

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.