Abstract
(1) Background: The volume-viscosity swallow test (V-VST) is a clinical tool for screening and diagnosis of oropharyngeal dysphagia (OD). Our aims were to examine the clinical utility of the V-VST against videofluoroscopy (VFS) or fiberoptic endoscopic evaluation of swallow (FEES) and to map the V-VST usage with patients at risk of OD across the years since it was described for the first time, carrying a systematic and a scoping review. (2) Methods: We performed both a systematic review (SR) including studies that look at the diagnostic test accuracy, and a scoping review (ScR) with articles published from September 2008 to May 2020. Searches were done in different databases, including PubMed and EMBASE from September 2008 until May 2020, and no language restrictions were applied. A meta-analysis was done in the SR to assess the psychometric properties of the V-VST. Quality of studies was assessed by Dutch Cochrane, QUADAS, GRADE (SR), and STROBE (ScR) criteria. The SR protocol was registered on PROSPERO (registration: CRD42020136252). (3) Results: For the diagnostic accuracy SR: four studies were included. V-VST had a diagnostic sensitivity for OD of 93.17%, 81.39% specificity, and an inter-rater reliability Kappa = 0.77. Likelihood ratios (LHR) for OD were 0.08 (LHR–) and 5.01 (LHR+), and the diagnostic odds ratio for OD was 51.18. Quality of studies in SR was graded as high with low risk of bias. In the ScR: 34 studies were retrieved. They indicated that V-VST has been used internationally to assess OD’s prevalence and complications. (4) Conclusions: The V-VST has strong psychometric properties and valid endpoints for OD in different phenotypes of patients. Our results support its utility in the screening and clinical diagnosis and management of OD.
Highlights
Oropharyngeal dysphagia (OD) is a condition recognized by the World Health Organization (WHO), classified in the International Statistical Classification of Diseases and Related Health Problems with the codes ICD-9: 787.2 and ICD-10: R13 [1]
volume-viscosity swallow test (V-VST) psychometrics support it as a tool to detect patients at risk for dysphagia when used by nurses or general practitioners, in this case we describe it as an easy, quick, and accurate screening tool [9]
The aims of this study were to evaluate the psychometric properties of the V-VST in the screening and diagnosis of oropharyngeal dysphagia (OD), to evaluate its role in detecting impaired efficacy and impaired safety of swallow, and to map V-VST utility and usage reported in the literature since 2008, when the test was first described [7]
Summary
Oropharyngeal dysphagia (OD) is a condition recognized by the World Health Organization (WHO), classified in the International Statistical Classification of Diseases and Related Health Problems with the codes ICD-9: 787.2 and ICD-10: R13 [1]. It is highly prevalent among several underlying pathologies and varies according to the severity of the concomitant disease, affecting up to 27% of community-dwelling older adults, over 50% of hospitalized or institutionalized older patients, 50% of stroke patients, from 24% to 86%. One-year mortality of older patients with OD and malnutrition discharged from general hospitals is 65% [5]. The diagnostic algorithm of OD requires a three-step approach consisting of clinical screening and clinical and instrumental assessment [3]
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