Diagnostic accuracy of lateral neck radiography in ruling out supraglottitis: a prospective observational study

Fujiwara, Takashi; Okamoto, Hiroshi; Ohnishi, Yasuhiro; Fukuoka, Toshio; Ichimaru, Kazuyuki

doi:10.1136/emermed-2013-203340

Cited by 11 publications

(7 citation statements)

References 13 publications

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“…Because six studies of the eight included studies used the two‐gate study design, the patient selection domain and flow and timing domain had a high risk of bias and of invalid applicability. In five of the eight studies included, the index test was interpreted without the results of the reference standard . Due to the nature of the research, laryngoscopic evaluation was carried out after the index test.…”

Section: Resultsmentioning

confidence: 99%

“…Fujiwara et al . prospectively enrolled 105 adult patients who had undergone lateral neck radiographs to evaluate supraglottitis . One radiologist and one emergency physician, who were blind to patients’ symptoms and laryngoscopic evaluations, interpreted lateral neck radiographs.…”

Section: Discussionmentioning

confidence: 99%

“…However, heterogeneity investigation suggested potential bias and it is difficult to generalize pooled diagnostic values obtained from this systematic review to the clinical setting. Second, many of the included studies lacked details of disease severity, even though the ability of lateral neck radiograph to detect supraglottitis depends on the severity of the edema in the supraglottic tissue . Recently, nasopharyngeal laryngoscopy, which is more informative than indirect laryngoscopy, has been in widespread use in the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic accuracy of radiographs for detecting supraglottitis: a systematic review and meta‐analysis

Fujiwara

Miyata

Tokumasu

et al. 2016

Acute Medicine & Surgery

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Aim: To assess the diagnostic performance of lateral radiograph of the neck for supraglottitis in adults and children. Methods: Electronic database searches (including PubMed, EMBASE, CINAHL, Web of Science, and WHO International Clinical Trials Registry Platform) were carried out through July 2014. Citations of included studies and recent narrative reviews were searched. Studies that compared lateral radiograph of the neck with a reference standard of direct/indirect laryngoscopy were included. Two reviewers independently assessed the methodological quality of included studies by Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2).Results: Of 2,088 potentially relevant citations, two single-gate (cohort) studies and six two-gate (case-control) studies were identified. These included studies of design are at the moderate or high risk of bias in QUADAS-2. The pooled sensitivity from bivariate random-effects regression was 92.9% (95% confidence interval [CI], 88.5-95.9%) and the pooled specificity was 89.2% (95% CI, 85.9-91.9%), but the diagnostic value would be overestimated because of selection bias in the six two-gate studies. The sensitivity and specificity of the single-gate studies were 100.0% (95% CI, 92.2-100.0%) and 30.6% (95% CI, 15.5-35.6%) in children and 81.0% (95% CI, 78.2-93.2%) and 85.7% specificity (95% CI, 78.2-93.2%) in adults.Conclusion: This study determines that there are insufficient studies of lateral neck radiograph for detecting supraglottitis. Lateral radiograph of the neck seems to have moderate accuracy for detecting supraglottitis. Further approximately unbiased studies are needed to obtain more valid and reliable estimates of test accuracy.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Diagnostic accuracy of radiographs for detecting supraglottitis: a systematic review and meta‐analysis

Fujiwara

Miyata

Tokumasu

et al. 2016

Acute Medicine & Surgery

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“…9 Kurashiki Central Hospital is an urban hospital with 1172 beds that serves 800,000 people in the western area of Okayama Prefecture, Japan. 10 This study was conducted and reported in accordance with the statement of the Japanese Society for Pharmacoepidemiology and the Standards for Reporting of Diagnostic Accuracy Studies criteria. [11][12][13] The study was approved by the institutional review board of Kurashiki Central Hospital and the Research Institute of Healthcare Data Science.…”

Section: Methodsmentioning

confidence: 99%

Identification and Validation of Hemophilia-Related Outcomes on Japanese Electronic Medical Record Database (Hemophilia-REAL V Study)

Fujiwara¹,

Miyakoshi²,

Kanemitsu³

et al. 2021

JBM

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Purpose: Routinely collected data are useful for epidemiological study in hemophilia, but few studies validated the algorithm accuracy. We aimed to develop and validate algorithms to identify patients with hemophilia A and hemophilia A-related events. Patients and Methods: This validation study compared data from medical chart reviews to a database of routinely collected health data, including claims data and discharge abstracts, and especially electronic medical records (EMR), at a single Japanese hospital (Kurashiki Central Hospital) using a stratified sampling method. Two physicians reviewed the charts for all patients at high risk for hemophilia A, and randomly sampled patients with moderate risk. Diagnostic accuracy was determined based on sensitivity, specificity, positive predictive value (PPV), and negative predictive value. Results: There were 1,033,845 eligible patients, of whom 31 had a diagnosis of hemophilia A. ICD-10 diagnosis code D66 in the EMR identified hemophilia A with a sensitivity of 93.5% (95% confidence interval: 78.6-99) and PPV of 61.7% (95% confidence interval: 46.4-75.5). The administration of ≥10,000 units/month of factor VIII products, as documented in the EMR, identified 81.3% of patients with prophylactic factor replacement therapy. The ICD-10 diagnosis code for intracranial bleeding in the EMR identified 75.0% of patients with intracranial bleeding, but those of gastrointestinal bleeding and major joint bleeding identified only 11.1% and 1.7%, respectively. Conclusion:We developed and validated algorithms to identify congenital hemophilia A and hemophilia A-related events. Hemophilia A could be identified with high sensitivity and PPV, but it was still challenging to identify hemophilia A-related events.

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“…9 Lateral soft tissue cervical X-ray examination is also easy to be performed on children, approximately 83% if compared to CT scan examination. 10 Flexible fiberoptic laryngoscopy as the gold standard examination of larynx is not always available in all hospitals, and the high cost of the examination inspires the researchers to conduct a comparison of lateral soft tissue cervical X-ray examination with flexible fiberoptic laryngoscopy examination on patients of LPR with LTH, with expectation that it could be used as a reference for assessment and diagnostic support. The researchers believe that the X-ray examination could be useful in providing an overall view towards LTH manifestations, therefore, an LTH diagnosis could be made based on radiological examination.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic of lingual tonsil hypertrophy with lateral soft tissue cervical X-ray on laryngopharyngeal reflux

Asyari

Novialdi

Murizky

et al. 2021

Oto Rhino Laryn Indones

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Background: Lingual tonsil hypertrophy (LTH) evaluation could be performed by flexible fiberoptic laryngoscopy, lateral soft tissue cervical roentgen, CT scan, and magnetic resonance imaging (MRI).Lateral soft tissue cervical roentgen examination was considered as substitutes for diagnostic testing of LTH, which, aside from being cheaper, the examination could also be conducted in all hospitals and easy to be performed on children. Objective: To compare the lingual tonsil enlargement with examination procedure using lateral soft tissue cervical roentgen as an LTH diagnosis measure compared to the flexible fiberoptic laryngoscopy examination as the gold standard examination. Methods: A cross-sectional design study on 30 respondents of laryngopharyngeal reflux (LPR) patients whose conducted routine ENT physical examination, followed by flexible fiberoptic laryngoscopy examination along with lateral soft tissue cervical roentgen. Results: The sensitivity level of 65.38% was acquired from the statistical tests, along with specificity level of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 30.37%. Conclusions: Based on sensitivity and specificity, lateral soft tissue cervical roentgen examination could already be used as a diagnostic measure and have an accurate capability to diagnose LTH.

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Diagnostic accuracy of lateral neck radiography in ruling out supraglottitis: a prospective observational study

Abstract: UMIN000011928.

Cited by 11 publications

References 13 publications

Diagnostic accuracy of radiographs for detecting supraglottitis: a systematic review and meta‐analysis

Diagnostic accuracy of radiographs for detecting supraglottitis: a systematic review and meta‐analysis

Identification and Validation of Hemophilia-Related Outcomes on Japanese Electronic Medical Record Database (Hemophilia-REAL V Study)

Diagnostic of lingual tonsil hypertrophy with lateral soft tissue cervical X-ray on laryngopharyngeal reflux

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