Reference
Reference
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Study Type
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Patients/Events
Study Objective(Purpose of Study)
Study Objective(Purpose of Study)
Study Results
Study Results
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Study Quality
1. Kuo P, Holloway RH, Nguyen NQ. Current and future techniques in the evaluation of dysphagia. J Gastroenterol Hepatol. 2012; 27(5):873-881. Review/Other-Dx N/A To review the current clinical and laboratory assessments of dysphagia and the emerging techniques that have been developed recently that allows better understanding of esophageal motor function. No results stated in abstract. 4
2. Wilkins T, Gillies RA, Thomas AM, Wagner PJ. The prevalence of dysphagia in primary care patients: a HamesNet Research Network study. J Am Board Fam Med. 2007; 20(2):144-150. Review/Other-Dx 947 patients To determine the prevalence of dysphagia in primary care patients. Of the 947 study participants, 214 (22.6%) reported dysphagia occurring several times per month or more frequently. Those reporting dysphagia were more likely to be women (80.8% women vs 19.2% men, P=.002) and older (mean age of 48.1 in patients with dysphagia vs mean age of 45.7 in patients without dysphagia, P=.001). 64% of patients with dysphagia indicated that they were concerned about their symptoms, but 46.3% had not spoken with their doctor about their symptoms. Logistic regression analyses showed that increased frequency (OR = 2.15, 95% CI, 1.41-3.30), duration (OR = 1.91, CI 1.24-2.94), and concern (OR = 2.64, CI 1.36-5.12) of swallowing problems as well as increased problems eating out (OR = 1.72, CI 1.19-2.49) were associated with increased odds of having talked to a physician. 4
3. Cook IJ. Oropharyngeal dysphagia. Gastroenterol Clin North Am. 2009; 38(3):411-431. Review/Other-Dx N/A To review oropharyngeal dysphagia. No results stated in abstract. 4
4. Garon BR, Sierzant T, Ormiston C. Silent aspiration: results of 2,000 video fluoroscopic evaluations. J Neurosci Nurs. 2009; 41(4):178-185; quiz 186-177. Review/Other-Dx 2,000 patients Retrospectively study aspiration and silent aspiration to increase the awareness of nursing staffs of the diagnostic pathology groups associated with silent aspiration. 51% of patients aspirated on the video fluoroscopic evaluation. Of the patients who aspirated, 55% had no protective cough reflex (silent aspiration). The diagnostic pathology groups with the highest rates of silent aspiration were brain cancer, brainstem stroke, head-neck cancer, pneumonia, dementia/Alzheimer, chronic obstructive lung disease, seizures, myocardial infarcts, neurodegenerative pathologies, right hemisphere stroke, closed head injury, and left hemisphere stroke. 4
5. Wilcox CM, Alexander LN, Clark WS. Localization of an obstructing esophageal lesion. Is the patient accurate? Dig Dis Sci. 1995; 40(10):2192-2196. Observational-Dx 139 patients To determine if patient’s sensation of dysphagia can accurately localize obstructing esophageal lesions. Patients more accurate in localizing proximal rather than distal lesions, as distal lesions often cause referred dysphagia. 2
6. Logemann JA. Role of the modified barium swallow in management of patients with dysphagia. Otolaryngol Head Neck Surg. 1997; 116(3):335-338. Review/Other-Dx N/A Reviews role and technique of modified barium swallow in patients with oropharyngeal dysphagia. Modified barium swallow can be effective tool in rehabilitation of these patients. 4
7. Chen YM, Ott DJ, Gelfand DW, Munitz HA. Multiphasic examination of the esophagogastric region for strictures, rings, and hiatal hernia: evaluation of the individual techniques. Gastrointest Radiol. 1985; 10(4):311-316. Observational-Dx 159 patients To compare radiographic and endoscopic sensitivities in patients with lower esophageal rings. 95% of lower esophageal rings detected by barium esophagography vs 76% by endoscopy. Radiographic examination more accurate. 3
8. Levine MS, Rubesin SE. Radiologic investigation of dysphagia. AJR Am J Roentgenol. 1990; 154(6):1157-1163. Review/Other-Dx N/A Presents a practical approach for radiologic investigation of dysphagia. The radiologic examination of the pharynx and esophagus should be tailored according to the nature and location of dysphagia. 4
9. Hartl DM, Kolb F, Bretagne E, Marandas P, Sigal R. Cine magnetic resonance imaging with single-shot fast spin echo for evaluation of dysphagia and aspiration. Dysphagia. 2006; 21(3):156-162. Review/Other-Dx 6 patients To determine the feasibility of and interest in evaluation of swallowing using cine-MRI in patients with dysphagia and aspiration caused by an abnormal pharyngeal phase of swallow. Cine-MRI using the dry swallow technique is feasible and without risk in patients with clinical aspiration. Cine-MRI is complementary to clinical evaluation of swallowing in patients with an abnormal pharyngeal phase of swallowing resulting from treatment of cancer. 4
10. Kulinna-Cosentini C, Schima W, Lenglinger J, et al. Is there a role for dynamic swallowing MRI in the assessment of gastroesophageal reflux disease and oesophageal motility disorders? Eur Radiol. 2012; 22(2):364-370. Observational-Dx 37 patients To evaluate the diagnostic value of dynamic MRI swallowing in patients with symptoms of gastroesophageal reflux disease. MRI results were concordant with pH-metry in 82% (23/28) of patients diagnosed with abnormal oesophageal acid exposure by pH-metry. 5 patients demonstrated typical symptoms of gastroesophageal reflux disease and had positive findings with pH monitoring, but false negative results with MRI. In 4/6 patients (67%), there was a correct diagnosis of oesophageal motility disorder, according to manometric criteria, on dynamic MRI. The overall accuracy of MRI diagnoses was 79% (27/34). A statistically significant difference was found between the size of hiatal hernia, grade of reflux in MRI, and abnormal acid exposure on pH-monitoring. 3
11. Fujii N, Inamoto Y, Saitoh E, et al. Evaluation of swallowing using 320-detector-row multislice CT. Part I: single- and multiphase volume scanning for three-dimensional morphological and kinematic analysis. Dysphagia. 2011; 26(2):99-107. Review/Other-Dx 3 patients To perform a single-phase volume scanning and multiphase volume scanning on patients and to create 3D and 4D images to evaluate the feasibility of morphologic and kinematic analysis of swallowing using 320-MSCT. The single-phase 3D images clearly and accurately showed the structures involved in swallowing, and the multiphase 3D images were able to show the oral stage to the early esophageal stage of swallowing, allowing a kinematic analysis of swallowing. A reclining chair that allows scanning to be performed with the subject in a semisitting position, which makes swallowing evaluation by 320-MSCT applicable not only to research on healthy swallowing but also to the clinical examination of dysphagia patients. 4
12. Inamoto Y, Fujii N, Saitoh E, et al. Evaluation of swallowing using 320-detector-row multislice CT. Part II: kinematic analysis of laryngeal closure during normal swallowing. Dysphagia. 2011; 26(3):209-217. Observational-Dx 6 patients To (1) depict normal dynamic swallowing and (2) measure (a) the temporal characteristics of three components of laryngeal closure, ie, true vocal cord (TVC) closure, closure of the laryngeal vestibule at the arytenoid to epiglottic base, and epiglottic inversion, and (b) the temporal relationship between these levels of laryngeal closure and other swallowing events, hyoid elevation, and the pharyngoesophageal segment using 320-MSCT. The swallowing of a 10-ml portion of honey-thick liquid (5% w/v) was examined in 6 healthy volunteers placed in a 45 degrees reclining position. 3D CT images were created in 29 phases at an interval of 0.10 s over a 2.90-s duration. Dynamic swallowing and true vocal cord movement were depicted clearly. The sequence for laryngeal closure was the following: (1) the hyoid started to elevate, (2) the pharyngoesophageal segment opened, (3) true vocal cord closure and closure at the arytenoid to epiglottic base occurred almost simultaneously during the hyoid elevation, and (4) the epiglottic maximum inversion occurred after the hyoid maximum displacement. 4
13. Pikus L, Levine MS, Yang YX, et al. Videofluoroscopic studies of swallowing dysfunction and the relative risk of pneumonia. AJR Am J Roentgenol. 2003; 180(6):1613-1616. Observational-Dx 381 patients To determine relationship between swallowing dysfunction on barium studies and risk of aspiration pneumonia. Likelihood of developing aspiration pneumonia directly related to degree of swallowing dysfunction on barium studies. 3
14. Rubesin SE. Oral and pharyngeal dysphagia. Gastroenterol Clin North Am. 1995; 24(2):331-352. Review/Other-Dx N/A Reviews a radiologic approach for evaluating patients with pharyngeal swallowing disorders. Both structural and functional abnormalities of the pharynx can be well shown on barium studies. 4
15. Smith DF, Ott DJ, Gelfand DW, Chen MY. Lower esophageal mucosal ring: correlation of referred symptoms with radiographic findings using a marshmallow bolus. AJR Am J Roentgenol. 1998; 171(5):1361-1365. Review/Other-Dx 130 patients To determine the prevalence of lower esophageal mucosal rings and to correlate the relationship between these mucosal rings and the presence and anatomic level of symptoms evoked using a marshmallow bolus. Lower esophageal mucosal rings were shown in 26 (20%) of the patients. In 16 (62%) of the 26 patients, a marshmallow bolus became impacted at the ring. The impaction caused dysphagia in 12 (75%) of the 16 patients. In these 12 patients, dysphagia was referred to: 7- in the neck, 2- sternal angle, 2- mid chest, and 1- the lower chest. None of the 12 patients had a pharyngeal or cervical esophageal abnormality that would account for their symptoms. Because proximal referral of symptoms is common in patients with lower esophageal mucosal rings, a thorough radiographic examination of the entire esophagus and esophagogastric region is required regardless of the level of their swallowing complaints. 4
16. Schima W, Pokieser P, Schober E, et al. Globus sensation: value of static radiography combined with videofluoroscopy of the pharynx and oesophagus. Clin Radiol. 1996; 51(3):177-185. Observational-Dx 130 patients To determine diagnostic value of static images combined with videofluoroscopy vs either technique alone in patients with globus sensation. Videofluoroscopy combined with static images revealed significantly more abnormalities in pharynx and esophagus than either technique alone. 3
17. Levine MS, Chu P, Furth EE, Rubesin SE, Laufer I, Herlinger H. Carcinoma of the esophagus and esophagogastric junction: sensitivity of radiographic diagnosis. AJR Am J Roentgenol. 1997; 168(6):1423-1426. Observational-Dx 50 patients To determine sensitivity of double contrast esophagram in diagnosing cancer of esophagus and esophagogastric junction. Double contrast esophagography had sensitivity of 96% in diagnosing these tumors. 3
18. DiPalma JA, Prechter GC, Brady CE, 3rd. X-ray-negative dysphagia: is endoscopy necessary? J Clin Gastroenterol. 1984; 6(5):409-411. Review/Other-Dx 195 patients To determine if endoscopy increased chances of finding esophageal cancer in patients with radiographic-negative dysphagia. No cases of esophageal cancer found by endoscopy that had been missed on barium study. 4
19. Halpert RD, Feczko PJ, Spickler EM, Ackerman LV. Radiological assessment of dysphagia with endoscopic correlation. Radiology. 1985; 157(3):599-602. Observational-Dx 127 patients To determine frequency of abnormalities on biphasic esophagrams in patients with dysphagia and correlate with endoscopy. 77% of patients with dysphagia had abnormal barium studies; 3.3% had esophageal cancer; no cancers missed on barium study. 3
20. Ott DJ, Chen YM, Wu WC, Gelfand DW, Munitz HA. Radiographic and endoscopic sensitivity in detecting lower esophageal mucosal ring. AJR Am J Roentgenol.  1986; 147(2):261-265. Observational-Dx 60 patients To compare radiographic and endoscopic sensitivities in patients with lower esophageal rings. 95% of lower esophageal rings detected by barium esophagography vs 76% by endoscopy. Radiographic examination more accurate. 3
21. Ott DJ, Chen YM, Wu WC, Gelfand DW. Endoscopic sensitivity in the detection of esophageal strictures. J Clin Gastroenterol. 1985; 7(2):121-125. Observational-Dx 90 patients To determine endoscopic sensitivity in detecting peptic esophageal strictures. Barium studies detected 95% of all strictures. Endoscopy and radiology are equally effective and complementary methods. 3
22. Ott DJ, Gelfand DW, Lane TG, Wu WC. Radiologic detection and spectrum of appearances of peptic esophageal strictures. J Clin Gastroenterol. 1982; 4(1):11-15. Observational-Dx 80 patients To compare radiology and endoscopy in diagnosis of peptic strictures. Radiology detected 95% of all strictures. 3
23. Ott DJ, Richter JE, Chen YM, Wu WC, Gelfand DW, Castell DO. Esophageal radiography and manometry: correlation in 172 patients with dysphagia. AJR Am J Roentgenol. 1987; 149(2):307-311. Observational-Dx 172 patients To correlate radiographic and manometric findings in patients with dysphagia. Barium studies had overall sensitivity of 89% and specificity of 91% in diagnosing esophageal motility disorders. 3
24. Schima W, Stacher G, Pokieser P, et al. Esophageal motor disorders: videofluoroscopic and manometric evaluation--prospective study in 88 symptomatic patients. Radiology. 1992; 185(2):487-491. Observational-Dx 88 patients Prospective study to correlate videofluoroscopic and manometric findings in patients with dysphagia, chest pain, or scleroderma. Videofluoroscopy had overall sensitivity of 80% and specificity of 79% in diagnosing esophageal motility disorders. 2
25. Amaravadi R, Levine MS, Rubesin SE, Laufer I, Redfern RO, Katzka DA. Achalasia with complete relaxation of lower esophageal sphincter: radiographic-manometric correlation. Radiology. 2005; 235(3):886-891. Observational-Dx 21 patients Retrospective study to evaluate presence of complete lower esophageal sphincter relaxation on manometry in patients with achalasia on barium studies. Nearly one-third of patients with achalasia on barium studies had complete lower esophageal sphincter relaxation on manometry and symptoms resolved in all after treatment for achalasia. 3
26. de Oliveira JM, Birgisson S, Doinoff C, et al. Timed barium swallow: a simple technique for evaluating esophageal emptying in patients with achalasia. AJR Am J Roentgenol. 1997; 169(2):473-479. Observational-Dx 23 patients To define a simple technique for timing a barium swallow by which radiologists can assess esophageal emptying in patients with achalasia before and after minimally invasive therapy. There was no statistically significant difference between the percentage of emptying as measured on the digitized images and the H x W calculations or qualitative emptying percentage. Interobserver agreement for the area evaluated on the digitized films as well as the H x W measurements and qualitative estimates of emptying was almost perfect (the correlation coefficients being 0.99, 0.87, and 0.93, respectively). Both qualitative assessment and estimated change in area based on H x W measurements of the barium column are accurate methods of estimating esophageal emptying. 3
27. Andersson M, Lundell L, Kostic S, et al. Evaluation of the response to treatment in patients with idiopathic achalasia by the timed barium esophagogram: results from a randomized clinical trial. Dis Esophagus. 2009; 22(3):264-273. Observational-Tx 51 patients To assess the ability of TBE to predict symptoms and treatment failure during post-treatment follow-up and to determine whether esophageal emptying as assessed by TBE differs after treatment with pneumatic dilatation or laparoscopic myotomy. 51 patients with newly diagnosed achalasia were prospectively randomized to pneumatic dilatation (n=26) or laparoscopic myotomy (n=25). Evaluation with TBE was performed before (n=46) and after treatment (n=43). The median interval between treatment and post-treatment TBE was 6 months, and the median follow-up time after the post-treatment TBE was 18 months. Following therapeutic intervention, TBE parameters did not differ significantly between treatment groups. However, significant correlations were found between the height of the barium column at 1 min and the symptom scores at the end of follow-up for 'dysphagia for liquids' (P<0.05, rho = 0.47), 'chest pain' (P<0.05, rho = 0.42), and the 'Watson dysphagia score' (P<0.05, rho = 0.46). Patients with <50% improvement in this TBE-parameter (height at 1 min) post-treatment had a 40% risk of treatment failure during follow-up. 1
28. Paramsothy M, Goh KL, Kannan P. Oesophageal motility disorders: rapid functional diagnosis using computerised radionuclide oesophageal transit study. Singapore Med J. 1995; 36(3):309-313. Review/Other-Dx 10 patients To evaluate radionuclide esophageal transit studies for diagnosing esophageal dysmotility in patients with chest pain or dysphagia. All 10 patients had accurate diagnosis of esophageal dysmotility with this technique. 4
29. Stacey B, Patel P. Oesophageal scintigraphy for the investigation of dysphagia: in ans out of favour - underused when available. Eur J Nucl Med Mol Imaging. 2002; 29(9):1216-1220. Review/Other-Dx N/A Reviews role of radionuclide esophageal studies in patients with dysphagia. Esophageal scintigraphy is a simple, rapid, noninvasive test for assessing esophageal transit and function in a quantifiable way in patients with dysphagia. 4
30. Barloon TJ, Bergus GR, Lu CC. Diagnostic imaging in the evaluation of dysphagia. Am Fam Physician. 1996; 53(2):535-546. Review/Other-Dx N/A Reviews causes of oropharyngeal and esophageal dysphagia. Advocates barium study for diagnosing these lesions. 4
31. Phillips AJ, Nolan DJ. Radiology of oesophageal dysphagia. Br J Hosp Med. 1995; 53(9):458-466. Review/Other-Dx N/A Reviews spectrum of abnormalities that cause dysphagia. Advocates barium radiology as investigation of choice in patients with dysphagia. 4
32. Bhaijee F, Subramony C, Tang SJ, Pepper DJ. Human immunodeficiency virus-associated gastrointestinal disease: common endoscopic biopsy diagnoses. Patholog Res Int. 2011; 2011:247923. Review/Other-Dx N/A To review HIV associated gastrointestinal pathology with emphasis on common endoscopic biopsy diagnoses. No results stated in abstract. 4
33. Bonacini M, Young T, Laine L. The causes of esophageal symptoms in human immunodeficiency virus infection. A prospective study of 110 patients. Arch Intern Med. 1991; 151(8):1567-1572. Observational-Dx 110 patients Prospective study to determine the prevalence of infectious agents in patients with HIV infection and odynophagia or dysphagia, the utility of endoscopic, histologic, cytologic, and virologic testing for the diagnosis of esophagitis and the yield of blind brushings of the esophagus in this setting. 72/110 patients had a total of 100 esophageal infections. 33 had Candida alone, 22 had Candida and CMV. 50/55 patients with plaques alone had Candida, and 2 (4%) had only viral infection. The sensitivity of endoscopic brushings (95%) was better than that of histologic examination (70%) in the diagnosis of Candida esophagitis. Likewise, viral cultures of brushings or biopsy specimens were more sensitive (67%) than histologic examination (35%) for viral esophagitis. Blind brushing of the esophagus had a sensitivity and specificity for infectious esophagitis of 84% and 75%, respectively. Oral thrush had a sensitivity of 53% and a positive predictive value of 77% for Candida esophagitis. 3
34. Werneck-Silva AL, Prado IB. Role of upper endoscopy in diagnosing opportunistic infections in human immunodeficiency virus-infected patients. World J Gastroenterol. 2009; 15(9):1050-1056. Review/Other-Dx N/A To provide an update of the role of endoscopy in diagnosing opportunistic infection in the upper gastrointestinal tract in HIV-infected patients in the era of highly active antiretroviral therapy. Highly active antiretroviral therapy has dramatically decreased opportunistic infections in HIV-infected patients. However, gastrointestinal disease continues to account for a high proportion of presenting symptoms in these patients. Gastrointestinal symptoms in treated patients who respond to therapy are more likely to the result of drug-induced complications than opportunistic infection. Endoscopic evaluation of the gastrointestinal tract remains a cornerstone of diagnosis, especially in patients with advanced immunodeficiency, who are at risk for opportunistic infection. The peripheral blood CD4 lymphocyte count helps to predict the risk of an opportunistic infection, with the highest risk seen in HIV-infected patients with low CD4 count (<200 cells/mm(3)). 4
35. Wilcox CM, Schwartz DA, Clark WS. Esophageal ulceration in human immunodeficiency virus infection. Causes, response to therapy, and long-term outcome. Ann Intern Med. 1995; 123(2):143-149. Observational-Dx 100 Prospective cohort study to determine the causes of esophageal ulceration, the response rate to currently available therapies, and the long-term outcome in patients with HIV infection. Broad spectrum of causes of esophageal infection, each of which requires specific therapy, and many of which respond well to therapy. In light of these findings, it is important to do endoscopic evaluation with mucosal biopsy in patients with HIV infection so that a diagnosis can be established and appropriate therapy instituted. 2
36. Wilcox CM, Alexander LN, Clark WS, Thompson SE, 3rd. Fluconazole compared with endoscopy for human immunodeficiency virus-infected patients with esophageal symptoms. Gastroenterology. 1996; 110(6):1803-1809. Observational-Tx 134 patients A randomized study to compare outcomes, safety and cost-effectiveness of fluconazole compared with endoscopy as a treatment strategy for HIV-infected patients with new-onset esophageal symptoms. Empirical oral antifungal therapy with fluconazole is highly efficacious, safe, and cost-effective for HIV-infected patients with new-onset esophageal symptoms. 1
37. Balthazar EJ, Megibow AJ, Hulnick D, Cho KC, Beranbaum E. Cytomegalovirus esophagitis in AIDS: radiographic features in 16 patients. AJR Am J Roentgenol. 1987; 149(5):919-923. Review/Other-Dx 16 patients To assess radiographic findings in patients with CMV esophagitis. CMV esophagitis characterized by solitary or multiple ulcers, often large or deep. 4
38. Levine MS, Loevner LA, Saul SH, Rubesin SE, Herlinger H, Laufer I. Herpes esophagitis: sensitivity of double-contrast esophagography. AJR Am J Roentgenol. 1988; 151(1):57-62. Review/Other-Dx 25 patients To determine radiographic accuracy of double contrast esophagography in diagnosing herpes esophagitis. Abnormalities almost always detected on double contrast studies and in more than 50% of cases a specific diagnosis of herpes esophagitis could be made. 4
39. Levine MS, Macones AJ, Jr., Laufer I. Candida esophagitis: accuracy of radiographic diagnosis. Radiology. 1985; 154(3):581-587. Review/Other-Dx 34 patients Retrospective study to determine sensitivity of double contrast esophagram in diagnosing Candida esophagitis. Double contrast esophagography had sensitivity of 88%. 4
40. Levine MS, Woldenberg R, Herlinger H, Laufer I. Opportunistic esophagitis in AIDS: radiographic diagnosis. Radiology. 1987; 165(3):815-820. Review/Other-Dx 90 patients Retrospective study to determine ability of double contrast esophagram to differentiate fungal and viral esophagitis in patients with AIDS. Fungal and viral esophagitis usually differentiated on C/C studies without need for endoscopy. 4
41. Sor S, Levine MS, Kowalski TE, Laufer I, Rubesin SE, Herlinger H. Giant ulcers of the esophagus in patients with human immunodeficiency virus: clinical, radiographic, and pathologic findings. Radiology. 1995; 194(2):447-451. Review/Other-Dx 21 patients Retrospective study to determine if HIV and CMV ulcers in HIV-positive patients can be differentiated on clinical or radiographic criteria. It was not possible to differentiate giant HIV and CMV ulcers by these criteria, so endoscopy required for diagnosis. 4
42. Vahey TN, Maglinte DD, Chernish SM. State-of-the-art barium examination in opportunistic esophagitis. Dig Dis Sci. 1986; 31(11):1192-1195. Observational-Dx 25 patients Comparative study to determine sensitivity of double contrast esophagography in diagnosing Candida esophagitis. Double contrast esophagography had sensitivity of 92%. 2