Dysphagia diagnostic study of choice: Difference between revisions

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{{Dysphagia}}
{{Dysphagia}}
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{{CMG}}; {{AE}} {{HQ}}, {{FT}}
== Overview ==
== Overview ==
* The page name should be '''"[Disease name] diagnostic study of choice"''', with only the first letter of the title capitalized. Note that the page is called "Diagnostic study of choice."
The videofluorographic swallowing study is the gold standard for evaluating the patients presenting with dysphagia. VFSS provides information about delay in initiation of pharyngeal swallowing, nasopharyngeal regurgitation, residue of ingestate within the pharyngeal cavity after swallowing, and aspiration of ingestate.  
* '''Goal:'''
**To describe the most efficient/sensitive/specific test that is utilized for diagnosis of [disease name].
**To describe the gold standard test for the diagnosis of [disease name].
**To describe the diagnostic criteria, which may be based on clinical findings, physical exam signs, pathological findings, lab findings, findings on imaging, or even findings that exclude other diseases.
* As with all microchapter pages linking to the main page, at the top of the edit box put <nowiki>{{CMG}}</nowiki>, your name template, and the microchapter navigation template you created at the beginning.
* Remember to create links within WikiDoc by placing <nowiki>[[square brackets]]</nowiki> around key words which you want to link to other pages. Make sure you makes your links as specific as possible. For example, if a sentence contained the phrase anterior spinal artery syndrome, the link should be to [[anterior spinal artery syndrome]] not [[anterior]] or [[artery]] or [[syndrome]].  For more information on how to create links, click [[here]].
* Remember to follow the same format and capitalization of letters as outlined in the template below.
* You should include the name of the disease in the first sentence of every subsection.


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==
====Endoscopy Indications====
The endoscopy should be performed when the patient presented with symptoms of: <ref name="PhilpottGarg2017">{{cite journal|last1=Philpott|first1=Hamish|last2=Garg|first2=Mayur|last3=Tomic|first3=Dunya|last4=Balasubramanian|first4=Smrithya|last5=Sweis|first5=Rami|title=Dysphagia: Thinking outside the box|journal=World Journal of Gastroenterology|volume=23|issue=38|year=2017|pages=6942–6951|issn=1007-9327|doi=10.3748/wjg.v23.i38.6942}}</ref>
*[[Dysphagia|Difficulty swallowing]]
*[[Odynophagia|Painful swallowing]]
*When patient has risk of developing [[pneumonia]] due to [[aspiration]]


===== Template statements =====
===Video Fluoroscopic Swallowing Study===
 
Video fluoroscopic swallowing study, also known as modified barium swallow, is used as the initial study for the evaluation of oropharyngeal dysphagia. VFSS provides the following information about the oropharyngeal swallowing mechanism:<ref name="pmid18230864">{{cite journal| author=Logemann JA, Gensler G, Robbins J, Lindblad AS, Brandt D, Hind JA et al.| title=A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease. | journal=J Speech Lang Hear Res | year= 2008 | volume= 51 | issue= 1 | pages= 173-83 | pmid=18230864 | doi=10.1044/1092-4388(2008/013) | pmc=2894528 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18230864  }} </ref><ref name="pmid17549634">{{cite journal| author=Mainie I, Tutuian R, Patel A, Castell DO| title=Regional esophageal dysfunction in scleroderma and achalasia using multichannel intraluminal impedance and manometry. | journal=Dig Dis Sci | year= 2008 | volume= 53 | issue= 1 | pages= 210-6 | pmid=17549634 | doi=10.1007/s10620-007-9845-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17549634  }} </ref><ref name="pmid23150831">{{cite journal| author=Herbella FA| title=Critical analysis of esophageal multichannel intraluminal impedance monitoring 20 years later. | journal=ISRN Gastroenterol | year= 2012 | volume= 2012 | issue= | pages= 903240 | pmid=23150831 | doi=10.5402/2012/903240 | pmc=3488400 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23150831  }} </ref><ref name="pmid11213249">{{cite journal| author=Perry L, Love CP| title=Screening for dysphagia and aspiration in acute stroke: a systematic review. | journal=Dysphagia | year= 2001 | volume= 16 | issue= 1 | pages= 7-18 | pmid=11213249 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11213249  }} </ref>
=== Gold standard/Study of choice: ===
* Delay in initiation of pharyngeal swallowing
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* Nasopharyngeal regurgitation
* The following result of [gold standard test] is confirmatory of [disease name]:
* Residue of ingestate within the pharyngeal cavity after swallowing
** Result 1
* Aspiration of ingestate{{#ev:youtube|xu_YYOAlZEw}}
** Result 2
* The [name of the investigation] should be performed when:
** The patient presented with symptoms/signs 1. 2, 3.
** A positive [test] is detected in the patient.
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* The diagnostic study of choice for [disease name] is [name of the investigation].
* There is no single diagnostic study of choice for the diagnosis of [disease name].
* There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
* [Disease name] is mainly diagnosed based on clinical presentation.
* Investigations:
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
 
==== The comparison table for diagnostic studies of choice for [disease name] ====
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #FFFFFF; color: #FFFFFF; text-align: center;" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
|}
<small> ✔= The best test based on the feature </small>
 
===== Diagnostic results =====
The following result of [investigation name] is confirmatory of [disease name]:
* Result 1
* Result 2
 
===== Sequence of Diagnostic Studies =====
The [name of investigation] should be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
* A positive [test] is detected in the patient, to confirm the diagnosis.
 
=== Diagnostic Criteria ===
* Here you should describe the details of the diagnostic criteria.
*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for the diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
 
* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
 
* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:  
** Criteria 1
** Criteria 2
** Criteria 3
 
IF there are clear, established diagnostic criteria:
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
IF there are no established diagnostic criteria: 
*There are no established criteria for the diagnosis of [disease name].
 


==References==
==References==

Latest revision as of 17:13, 23 February 2018

Dysphagia Microchapters

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Diagnostic Study of Choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Feham Tariq, MD [3]

Overview

The videofluorographic swallowing study is the gold standard for evaluating the patients presenting with dysphagia. VFSS provides information about delay in initiation of pharyngeal swallowing, nasopharyngeal regurgitation, residue of ingestate within the pharyngeal cavity after swallowing, and aspiration of ingestate.

Diagnostic Study of Choice

Endoscopy Indications

The endoscopy should be performed when the patient presented with symptoms of: [1]

Video Fluoroscopic Swallowing Study

Video fluoroscopic swallowing study, also known as modified barium swallow, is used as the initial study for the evaluation of oropharyngeal dysphagia. VFSS provides the following information about the oropharyngeal swallowing mechanism:[2][3][4][5]

  • Delay in initiation of pharyngeal swallowing
  • Nasopharyngeal regurgitation
  • Residue of ingestate within the pharyngeal cavity after swallowing
  • Aspiration of ingestate{{#ev:youtube|xu_YYOAlZEw}}

References

  1. ↑ Philpott, Hamish; Garg, Mayur; Tomic, Dunya; Balasubramanian, Smrithya; Sweis, Rami (2017). "Dysphagia: Thinking outside the box". World Journal of Gastroenterology. 23 (38): 6942–6951. doi:10.3748/wjg.v23.i38.6942. ISSN 1007-9327.
  2. ↑ Logemann JA, Gensler G, Robbins J, Lindblad AS, Brandt D, Hind JA; et al. (2008). "A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease". J Speech Lang Hear Res. 51 (1): 173–83. doi:10.1044/1092-4388(2008/013). PMC 2894528. PMID 18230864.
  3. ↑ Mainie I, Tutuian R, Patel A, Castell DO (2008). "Regional esophageal dysfunction in scleroderma and achalasia using multichannel intraluminal impedance and manometry". Dig Dis Sci. 53 (1): 210–6. doi:10.1007/s10620-007-9845-x. PMID 17549634.
  4. ↑ Herbella FA (2012). "Critical analysis of esophageal multichannel intraluminal impedance monitoring 20 years later". ISRN Gastroenterol. 2012: 903240. doi:10.5402/2012/903240. PMC 3488400. PMID 23150831.
  5. ↑ Perry L, Love CP (2001). "Screening for dysphagia and aspiration in acute stroke: a systematic review". Dysphagia. 16 (1): 7–18. PMID 11213249.

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