进食评估问卷调查工具-10对吞咽障碍筛检价值的Meta分析

Value of EAT-10 in screening dysphagia: a meta-analysis

目的采用Meta分析方法探讨评价进食评估问卷调查工具-10(the eating assessment tool,EAT-10)诊断分界值为2和3分时,其对吞咽障碍的筛检价值。方法计算机检索2008年1月至2016年11月PubMed、Embase、Cochrane图书馆、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、万方数据库、维普数据库中使用EAT-10筛查吞咽障碍的诊断/筛检试验。采用"诊断精确性研究质量评价"(quality assessment of diagnostic accuracy studies,QUADAS)工具评价文献质量,Meta-DiSc1.4软件进行异质性检验和合并效应量的分析。结果共纳入3篇文献,合计394例研究对象。EAT-10诊断分界值为2分和3分时,其合并敏感度分别为0.84[95%CI(0.79,0.88)]和0.77[95%CI(0.71,0.82)],合并特异度分别为0.64[95%CI(0.55,0.72)]和0.74[95%CI(0.66,0.81)],EAT-10诊断分界值为2分时其漏诊率低于3分时,但误诊率要高于3分时;EAT-10诊断分界值为2分与3分时,其Q*指数分别为0.7 928和0.7 666,EAT-10诊断分界值为2分与3分时,其受试者诊断特征(receiver operating characteristic carve,SROC)曲线下面积(the area under carve,AUC)分别为0.8 621和0.8 343,表明分界值为2分时其诊断准确性相对高些,而且不管在2分时还是3分时EAT-10对吞咽障碍的诊断准确性均处于中等水平。结论 EAT-10能有效筛检出吞咽障碍患者,但分界值为2分和3分时其筛检效能有所差异,应综合考虑具体的临床情况确定最佳分界值。

Objective To evaluate the diagnostic value of the Eating Assessment Tool（EAT-10） in screening dysphagia by using2 and 3 as cut-off value with systematic review. Methods A retrieval on the diagnostic value of EAT-10 in dysphagia was done all through PubMed, Embase, the Cochrane Library, CBM, CNKI, WANFANG and VIP databases（from January 2008 to November 2016）. ＂Quality Assessment of Diagnostic Accuracy Studies＂（QUADAS） was used to appraise included papers. Meta-Disc1.4 software was used to analyze heterogeneity and the combined effect of the data. Results Three papers were included and 394 subjects were included in the review. By using 2 and 3 as the cut-off value of EAT-10, the value of the weighted sensitivity was 0.84 [95%CI（0.79, 0.88）] and 0.77 [95% CI（0.71,0.82）], the specificity was 0.64[95%CI（0.55, 0.72）] and 0.74 [95%CI（0.66, 0.81）],and the area under the receiver-operating-characteristic-curve（AUC-ROC） was 0.8621 and 0.8343, which illustrated the diagnostic accuracy of EAT-10 on dysphagia at the medium level.Conclusion The diagnostic ability of EAT-10 is good, but the sensitivity and specificity are different by using 2 and 3 as the cut-off value.The subjects should consider the specific clinical situation to determine the best cut-off value.