title: The reliability and validity of cervical auscultation in the diagnosis of dysphagia: a systematic review.
abstract: OBJECTIVE
  To systematically review the available evidence for the reliability and validity of cervical auscultation in diagnosing the several aspects of dysphagia in adults and children suffering from dysphagia.
  
  
  METHODS
  Medline (PubMed), Embase and the Cochrane Library databases.
  
  
  METHODS
  The systematic review was carried out applying the steps of the PRISMA-statement. The methodological quality of the included studies were evaluated using the Dutch 'Cochrane checklist for diagnostic accuracy studies'.
  
  
  RESULTS
  A total of 90 articles were identified through the search strategy, and after applying the inclusion and exclusion criteria, six articles were included in this review. In the six studies, 197 patients were assessed with cervical auscultation. Two of the six articles were considered to be of 'good' quality and three studies were of 'moderate' quality. One article was excluded because of a 'poor' methodological quality. Sensitivity ranges from 23%-94% and specificity ranges from 50%-74%. Inter-rater reliability was 'poor' or 'fair' in all studies. The intra-rater reliability shows a wide variance among speech language therapists.
  
  
  CONCLUSIONS
  In this systematic review, conflicting evidence is found for the validity of cervical auscultation. The reliability of cervical auscultation is insufficient when used as a stand-alone tool in the diagnosis of dysphagia in adults. There is no available evidence for the validity and reliability of cervical auscultation in children. Cervical auscultation should not be used as a stand-alone instrument to diagnose dysphagia.
authors: Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands Marloes.Lagarde@radboudumc.nl.
authors: Marloes L J
authors: ML
authors: Lagarde
authors: University Medical Center Utrecht, The Netherlands.
authors: Digna M A
authors: DM
authors: Kamalski
authors: Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands.
authors: Lenie
authors: L
authors: van den Engel-Hoek
mesh_terms: D000328:Adult; D001314:Auscultation / Q000379:methods* / Q000592:standards; D002648:Child; D057225:Data Mining / Q000379:methods; D016206:Databases, Bibliographic; D003680:Deglutition Disorders / Q000175:diagnosis*; D006801:Humans; D015203:Reproducibility of Results; D054928:Validation Studies as Topic
keywords: Cervical auscultation; dysphagia; reliability; swallowing; validity