Evidence map›Paper›PMID 28074215›Full record

Trial reportDer Nervenarzt2017

[Management of dysphagia in acute stroke : A prospective study for validation of current recommendations].

B Lindner-Pfleghar, H Neugebauer, S Stösser, J Kassubek, A Ludolph, R Dziewas, M Prosiegel, A Riecker

Abstract readClinical Trial
PubMed Publisher
In one paragraph

Trial report in Der Nervenarzt, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
5.1field-weighted citation impact, top 6% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
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

8 authors at 4 institutions in 1 country.

B Lindner-PflegharLogopädie, Universitäts- und Rehabilitationskliniken Ulm (RKU), Oberer Eselsberg 45, 89081, Ulm, Deutschland. beate.lindner-pfleghar@rku.de.
H NeugebauerKlinik für Neurologie, Universitätsklinikum Ulm, Ulm, Deutschland.
S StösserKlinik für Neurologie, Universitätsklinikum Ulm, Ulm, Deutschland.
J KassubekKlinik für Neurologie, Universitätsklinikum Ulm, Ulm, Deutschland.
A LudolphKlinik für Neurologie, Universitätsklinikum Ulm, Ulm, Deutschland.
R DziewasKlinik für Neurologie, Universitätsklinikum Münster, Münster, Deutschland.
M Prosiegel, München, Deutschland.
A RieckerKlinik für Neurologie und Rehabilitation, RehaNova GmbH, Köln, Deutschland.
University Hospital Ulm · DEMünchen Klinik · DEUniversity and Rehabilitation Clinics Ulm · DEUniversity Hospital Münster · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe German expert recommendations on the management of dysphagia in patients after acute stroke suggest an algorithm for clinical and technical investigations to identify patients at risk for aspiration and thus reduce the rate of aspiration pneumonia. The effectiveness of this algorithm has, however, not yet been prospectively validated .

methodsIn this study 144 consecutive stroke patients were assessed by a full bedside swallowing assessment including the screening procedures of standardized swallowing assessment (SSA) and 2 out of 6. Flexible endoscopic evaluation of swallowing (FEES) was performed in all patients.

resultsAspiration was diagnosed in 25 patients (17.4%) by FEES. The SSA predicted aspiration with a sensitivity of 76% and a specificity of 55.5% and the 2 out of 6 screening with a sensitivity of 68.0% and a specificity of 61.0%. Of the patients 7 with negative screening for 2 out of 6 and 6 patients with negative SSA showed silent aspiration with the penetration aspiration scale (PAS 8) during FEES (28% of all patients with aspiration). Significant predictors for aspiration were dysarthria, dysphonia, abnormal volitional cough and cough after swallowing water; however, in multivariable analysis only dysarthria and cough after swallowing water were identified as independent predictors for aspiration. The rate of aspiration pneumonia was 2.8%.

conclusionClinical screening alone is not sufficient to identify patients at risk for aspiration pneumonia. The FEES should be used at a low threshold in cases of severe stroke and minor clinical abnormalities, especially concerning isolated dysarthria and cough after swallowing water; therefore, current recommendations should be correspondingly modified.

Indexed as

Practice Guidelines as TopicAgedDeglutition DisordersFemaleGermanyGuideline AdherenceHumansMaleNeurologyPneumonia, AspirationReproducibility of ResultsRisk AssessmentSensitivity and SpecificityStrokeStroke RehabilitationTreatment OutcomeAcute strokeAspirationFlexible endoscopic evaluation of swallowing (FEES)Management of dysphagiaScreening

Identifiers

PMID28074215
OpenAlexW2568165937

What OpenQuestion holds

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Registered trials

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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.