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preserveAspectRatio="none"><path fill="none" stroke="#000" stroke-width="36" stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-fip-done" class="wsprkl btn" title="Dismiss find">✘</a></nav><nav id="jr-fip-info-p"><a id="jr-fip-prev" class="wsprkl btn" title="Jump to previuos match">◀</a><button id="jr-fip-matches">no matches yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style"><div class="fm-sec bkr_bottom_sep"><div class="bkr_thumb"><a href="https://www.nice.org.uk" title="National Institute for Health and Care Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng119er6-lrg.png" alt="Cover of Assessing and monitoring complications and comorbidities: feeding and nutritional problems" /></a></div><div class="bkr_bib"><h1 id="_NBK578090_"><span itemprop="name">Assessing and monitoring complications and comorbidities: feeding and nutritional problems</span></h1><div class="subtitle">Cerebral palsy in adults</div><p><b>Evidence review B3</b></p><p><i>NICE Guideline, No. 119</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Alliance (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2019 Jan</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3223-8</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div></div><div class="bkr_clear"></div></div><div id="chb3.s1"><h2 id="_chb3_s1_">Monitoring feeding and nutritional problems</h2><div id="chb3.s1.1"><h3>Review question</h3><p>B3 What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><div id="chb3.s1.1.1"><h4>Introduction</h4><p>Adults with cerebral palsy may experience problems with eating or feeding due to a number of co-morbidities. Difficulties with weakness, hand-eye co-ordination, muscle tone, gastro-oesophageal reflux, medications, positioning, carer training and behaviour can all lead to nutritional concerns and there may even be a need for enteral feeding tubes. This review question looks at the evidence available on effective ways of assessment and monitoring of feeding and nutrition.</p></div><div id="chb3.s1.1.2"><h4>PICO/PIRO table</h4><p>Please see <a class="figpopup" href="/books/NBK578090/table/chb3.tab1/?report=objectonly" target="object" rid-figpopup="figchb3tab1" rid-ob="figobchb3tab1">Table 1</a> for a summary of the Population, Intervention/Index test, Comparison/Reference standard and Outcome (PICO/PIRO) characteristics of this review.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figchb3tab1"><a href="/books/NBK578090/table/chb3.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figchb3tab1" rid-ob="figobchb3tab1"><img class="small-thumb" src="/books/NBK578090/table/chb3.tab1/?report=thumb" src-large="/books/NBK578090/table/chb3.tab1/?report=previmg" alt="Table 1. Summary of the protocol (PICO/PIRO table)." /></a><div class="icnblk_cntnt"><h4 id="chb3.tab1"><a href="/books/NBK578090/table/chb3.tab1/?report=objectonly" target="object" rid-ob="figobchb3tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Summary of the protocol (PICO/PIRO table). </p></div></div><p>For full details see review protocol in <a href="#chb3.appa">appendix A</a>.</p></div><div id="chb3.s1.1.3"><h4>Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual 2014</a>. Methods specific to this review question are described in the review protocol in <a href="#chb3.appa">appendix A</a> and for a full description of the methods see <a href="/books/n/niceng119erbm3/?report=reader" class="toc-item">supplementary document C</a>.</p><p>As GRADE is designed only for RCTs and observational studies, a modified version of this tool was used in order to appraise the confidence in the included diagnostic test accuracy evidence. The QUADAS-2 checklist risk of bias and applicability items were used for evaluating the risk of bias and indirectness, respectively, of the studies. The quality assessment of inconsistency and imprecision were adapted to take into account the methodological features of diagnostic studies.</p><p>Declaration of interests were recorded according to NICE’s 2014 conflicts of interest policy from May 2016 until April 2018. From April 2018 onwards they were recorded according to NICE’s 2018 <a href="https://www.nice.org.uk/About/Who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">conflicts of interest policy</a>. Those interests declared until April 2018 were reclassified according to NICE’s 2018 conflicts of interest policy (see Interests Register).</p></div><div id="chb3.s1.1.4"><h4>Clinical evidence</h4><div id="chb3.s1.1.4.1"><h5>Included studies</h5><p>One prospective observational study was included (<a class="bibr" href="#chb3.s1.ref1" rid="chb3.s1.ref1">Benigni 2011</a>; number of participants in study, N=365) which evaluated a malnutrition screening tool in adults with CP (MST-CP). This tool was based on a score obtained from measuring four variables: body weight < 40 kg; uncomfortable or impossible sitting position; partial or total help needed for eating; and suspicion of gastro-oesophageal reflux. The highest score possible was 21 points. A score higher than 10 points indicated high risk (severe malnutrition). A score higher than 0 and less than 10 points indicated mild risk (moderate malnutrition). A score equal to 0 indicated low risk (no malnutrition). The overall accuracy of this screening tool was evaluated by comparing its diagnostic accuracy with a composite reference standard based on three variables: weight loss from usual body weight; BMI; and albuminuria.</p><p>The clinical studies included in this evidence review are summarised in <a class="figpopup" href="/books/NBK578090/table/chb3.tab2/?report=objectonly" target="object" rid-figpopup="figchb3tab2" rid-ob="figobchb3tab2">Table 2</a> and evidence from these are summarised in the clinical evidence profile below (<a class="figpopup" href="/books/NBK578090/table/chb3.tab3/?report=objectonly" target="object" rid-figpopup="figchb3tab3" rid-ob="figobchb3tab3">Table 3</a>).</p><p>See also the search strategy in <a href="#chb3.appb">appendix B</a>, study selection flow chart in <a href="#chb3.appc">appendix C</a>, clinical evidence tables in <a href="#chb3.appd">appendix D</a> and forest plots in <a href="#chb3.appe">appendix E</a>.</p><p>No studies were included that evaluated dietary, clinical or anthropometric assessments as tools to screen for risk of malnutrition in adults with cerebral palsy.</p></div><div id="chb3.s1.1.4.2"><h5>Excluded studies</h5><p>Studies excluded from this systematic review, with reasons for their exclusion, are provided in <a href="#chb3.appk">appendix K</a>.</p></div></div><div id="chb3.s1.1.5"><h4>Summary of clinical studies included in the evidence review</h4><p><a class="figpopup" href="/books/NBK578090/table/chb3.tab2/?report=objectonly" target="object" rid-figpopup="figchb3tab2" rid-ob="figobchb3tab2">Table 2</a> provides a brief summary of the included studies.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figchb3tab2"><a href="/books/NBK578090/table/chb3.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figchb3tab2" rid-ob="figobchb3tab2"><img class="small-thumb" src="/books/NBK578090/table/chb3.tab2/?report=thumb" src-large="/books/NBK578090/table/chb3.tab2/?report=previmg" alt="Table 2. Summary of included studies." /></a><div class="icnblk_cntnt"><h4 id="chb3.tab2"><a href="/books/NBK578090/table/chb3.tab2/?report=objectonly" target="object" rid-ob="figobchb3tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of included studies. </p></div></div><p>See <a href="#chb3.appd">appendix D</a> for the full evidence tables.</p></div><div id="chb3.s1.1.6"><h4>Quality assessment of clinical outcomes included in the evidence review</h4><p>The clinical evidence profile for this comparison is presented in <a class="figpopup" href="/books/NBK578090/table/chb3.tab3/?report=objectonly" target="object" rid-figpopup="figchb3tab3" rid-ob="figobchb3tab3">Table 3</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figchb3tab3"><a href="/books/NBK578090/table/chb3.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figchb3tab3" rid-ob="figobchb3tab3"><img class="small-thumb" src="/books/NBK578090/table/chb3.tab3/?report=thumb" src-large="/books/NBK578090/table/chb3.tab3/?report=previmg" alt="Table 3. Summary of clinical evidence of MST-CP (at thresholds of 0 and 10) to differentiate between high risk and low risk of malnutrition in adults with cerebral palsy." /></a><div class="icnblk_cntnt"><h4 id="chb3.tab3"><a href="/books/NBK578090/table/chb3.tab3/?report=objectonly" target="object" rid-ob="figobchb3tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Summary of clinical evidence of MST-CP (at thresholds of 0 and 10) to differentiate between high risk and low risk of malnutrition in adults with cerebral palsy. </p></div></div><p>See <a href="#chb3.appf">appendix F</a> for the full GRADE table.</p></div><div id="chb3.s1.1.7"><h4>Economic evidence</h4><div id="chb3.s1.1.7.1"><h5>Included studies</h5><p>A systematic review of the economic literature was conducted but no studies were identified which were applicable to this review question.</p></div><div id="chb3.s1.1.7.2"><h5>Excluded studies</h5><p>No studies were identified which were applicable to this review question.</p></div></div><div id="chb3.s1.1.8"><h4>Summary of studies included in the economic evidence review</h4><p>No economic evaluations were included in this review.</p></div><div id="chb3.s1.1.9"><h4>Economic model</h4><p>This topic was not prioritised for health economic modelling because the committee assumed that better recognition would lead to earlier identification of possible nutritional deficits and more timely treatment. This would therefore be cost-neutral or cost saving.</p></div><div id="chb3.s1.1.10"><h4>Resource impact</h4><p>No unit costs were presented to the committee as these were not prioritised for decision making purposes.</p></div><div id="chb3.s1.1.11"><h4>Evidence statements</h4></div><div id="chb3.s1.1.12"><h4>Screening tools - Malnutrition Screening Tool for adults with cerebral palsy (MST-CP)</h4><div id="chb3.s1.1.12.1"><h5>Critical outcomes</h5><div id="chb3.s1.1.12.1.1"><h5>Function</h5><p>No evidence was found for this outcome.</p></div><div id="chb3.s1.1.12.1.2"><h5>Health related quality of life</h5><p>No evidence was found for this outcome.</p></div><div id="chb3.s1.1.12.1.3"><h5>Chest infection</h5><p>No evidence was found for this outcome.</p></div></div><div id="chb3.s1.1.12.2"><h5>Important outcomes</h5><div id="chb3.s1.1.12.2.1"><h5>Patient satisfaction</h5><p>No evidence was found for this outcome.</p></div><div id="chb3.s1.1.12.2.2"><h5>Mortality</h5><p>No evidence was found for this outcome.</p></div><div id="chb3.s1.1.12.2.3"><h5>Weight</h5><p>No evidence was found for this outcome.</p></div><div id="chb3.s1.1.12.2.4"><h5>Skin integrity</h5><p>No evidence was found for this outcome.</p></div><div id="chb3.s1.1.12.2.5"><h5>Feeding time</h5><p>No evidence was found for this outcome.</p></div><div id="chb3.s1.1.12.2.6"><h5>Diagnostic accuracy for malnutrition</h5><ul id="l199"><li id="lt607" class="half_rhythm"><div>Low quality evidence from 1 observational study (N=356) found that the Malnutrition Screening Tool for adults with cerebral palsy (MST-CP) with a score of 0 points had moderate sensitivity (78%) and low specificity (51%) for detecting risk of malnutrition in adults with cerebral palsy. The positive and negative likelihood ratios of 1.60 and 0.42 respectively suggest this test is not useful for ruling malnutrition in or out.</div></li><li id="lt608" class="half_rhythm"><div>Moderate quality evidence from 1 observational study (N=356) found that MST-CP with a score higher than 10 points had a low sensitivity (55%) and a moderate specificity (87%) for detecting risk of malnutrition in adults with cerebral palsy. The positive and negative likelihood ratios of 4.24 and 0.51 respectively suggess suggest this test is not useful for ruling malnutrition in or out.</div></li></ul></div></div></div><div id="chb3.s1.1.13"><h4>The committee’s discussion of the evidence</h4><div id="chb3.s1.1.13.1"><h5>Interpreting the evidence</h5><div id="chb3.s1.1.13.1.1"><h5>The outcomes that matter most</h5><p>Function, health-related quality of life, and chest infection were considered to be the critical outcomes because problems with feeding and swallowing can have serious adverse effects on health and wellbeing. Patient satisfaction, mortality, weight, skin integrity, feeding time and TOMS (Therapy Outcome Measures-Swallowing) were considered to be the important outcomes for this question.</p><p>Nutritional status was reported in the included study, but there was no evidence for the critical outcomes: function, health-related quality of life, and chest infection or the important outcomes: patient satisfaction, mortality, weight, skin integrity, feeding time and TOMS. The included studies reported how accurate the tools were in identifying nutritional status. In the absence of any other outcomes the committee considered statistical accuracy measures (such as sensitivity and specificity, as well as positive and negative likelihood ratios) because it was assumed that a more accurate assessment would lead to better management of the nutritional problem and therefore better patient level outcome.</p></div><div id="chb3.s1.1.13.1.2"><h5>The quality of the evidence</h5><p>The quality of the evidence was assessed using a GRADE approach modified for diagnostic test accuracy reviews (see <a href="/books/n/niceng119erbm3/?report=reader" class="toc-item">supplementary document C</a> for methods). The quality of the diagnostic accuracy outcomes ranged from moderate to low. The quality was downgraded due to risk of bias and imprecision in the diagnostic accuracy estimates.</p><p>Although there was some evidence for one nutritional screening tool, due to the absence of evidence about other dietary, clinical or anthropometric assessments the committee based their recommendations mainly on their expertise and experience.</p></div><div id="chb3.s1.1.13.1.3"><h5>Benefits and harms</h5><p>The committee noted that healthy eating and healthy weight (and body mass index) is as important for adults with cerebral palsy as it is in the general population and that checking weight is therefore important. Based on their experience the committee agreed that there are some factors related to feeding behaviour and ability to feed themselves that may indicate that the adult with cerebral palsy is likely to lose or gain weight. Recognising these early to target treatment is important to improve outcomes and therefore a discussion should be had with the adult with cerebral palsy and their family to see whether their feeding behaviour or ability has changed.</p><p>Based on their experience and expertise the committee considered that undernutrition and obesity in adults with cerebral palsy can be influenced by a variety of elements. These elements (for example medications, carers’ support, and feeding abilities and problems) can be either a cause of an improvement in nutritional status and appetite, or a consequence of deterioration in appetite (for example through side effect of medications). They therefore made recommendations to be aware of these factors in prescribing medications, when addressing undernutrition and obesity in adults with cerebral palsy. A discussion should take place at every review about such factors to be able to address them early and prevent undernutrition or excessive weight gain.</p><p>Based on their knowledge the committee discussed that adults with dyskinetic cerebral palsy or severe spastic cerebral palsy may have an increased metabolic rate and need to increase their calorie intake to account for this. The committee recognised that reduction in dyskinesia or spasticity by treatment such as intrathecal baclofen may result in weight gain. They agreed that this is under-recognised in practice and that greater awareness of this could help people to achieve the appropriate calorie intake according to their individual needs.</p><p>Due to the serious consequences that malnutrition can have the committee agreed that formal and informal carers should receive training on the recognition of malnutrition and feeding difficulties to prevent ill health, in line with NICE’s guideline on <a href="https://www.nice.org.uk/guidance/cg32" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">nutrition support for adults</a>.</p><p>The committee agreed that feeding difficulties and malnutrition have severe and potentially life threatening consequences and therefore decided that it would be necessary to refer adults with cerebral palsy to a specialist appropriate to their individual needs. Due to this risks associated with these difficulties and malnutrition the committee decided, based on consensus to make this a strong recommendation.</p><p>On consideration of the limited evidence the committee agreed that there are many individual factors that could relate to feeding and nutritional problems and that the assessment therefore needs to be tailored to each adult with cerebral palsy. This means that there is not one tool that should be given to adults with cerebral palsy that is better than all other ones. The committee therefore did not prioritise this for further research because assessment would have to be individualised according to each adult’s needs and circumstances.</p></div></div><div id="chb3.s1.1.13.2"><h5>Cost effectiveness and resource use</h5><p>The committee noted that no relevant published economic evaluations had been identified for this topic.</p><p>The committee considered that the recommendations made were unlikely to result in a substantial increase in resource use. Any additional costs would be small, given the minimal change in practice, and any increase would be offset by a reduction in the costs associated with dealing with malnutrition.</p></div><div id="chb3.s1.1.13.3"><h5>Other factors the committee took into account</h5><p>The committee also noted that the NICE guideline on <a href="https://www.nice.org.uk/guidance/cg189" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">obesity: identification, assessment and management</a> includes generic information on the identification and assessment of obesity in all adults which can be generalised to people with cerebral palsy. They therefore cross-referenced to this.</p><p>The committee acknowledged that the identification of malnutrition in adults without cerebral palsy was covered in detail in the NICE guideline CG32 on <a href="https://www.nice.org.uk/guidance/cg32" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">nutrition support for adults</a>. They decided that the general principles of recognition of malnutrition including the use of tools (for example the Malnutrition Universal Screening Tool), would be generalisable to adults with cerebral palsy. The committee therefore cross-referred to this guideline.</p></div></div></div><div id="rl.r7"><h3>References</h3><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="chb3.s1.ref1"><p id="p-101">
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<strong>Benigni 2011</strong>
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</p>Benigni, I., Devos, P., Rofidal, T., Seguy, D., The CP-MST, a malnutrition screening tool for institutionalized adult cerebral palsy patients, Clinical Nutrition, 30, 769–773, 2011 [<a href="https://pubmed.ncbi.nlm.nih.gov/21764187" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21764187</span></a>]</div></p></li></ul></div></div><div id="appendixes.appgroupb3"><h2 id="_appendixes_appgroupb3_">Appendices</h2><div id="chb3.appa"><h3>Appendix A. Review protocols</h3><p>Review protocol for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><p id="chb3.appa.et1"><a href="/books/NBK578090/bin/chb3-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 4. Review protocol for monitoring feeding and nutritional problems</a><span class="small"> (PDF, 330K)</span></p></div><div id="chb3.appb"><h3>Appendix B. Literature search strategies</h3><p>Literature search strategies for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><div id="chb3.appb.s1"><h4>Database: Medline & Embase (Multifile)</h4><p>Database(s): Embase 1974 to 2018 March 22, Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) 1946 to Present.</p><p id="chb3.appb.tab1"><a href="/books/NBK578090/table/chb3.appb.tab1/?report=objectonly" target="object" rid-ob="figobchb3appbtab1" class="figpopup">Table 5. Last search on 22 March 2018</a></p></div><div id="chb3.appb.s2"><h4>Database: Cochrane Library</h4><p id="chb3.appb.tab2"><a href="/books/NBK578090/table/chb3.appb.tab2/?report=objectonly" target="object" rid-ob="figobchb3appbtab2" class="figpopup">Table 6. Last searched on 22 March 2018</a></p></div><div id="chb3.appb.s3"><h4>Database: Web of Science</h4><p id="chb3.appb.tab3"><a href="/books/NBK578090/table/chb3.appb.tab3/?report=objectonly" target="object" rid-ob="figobchb3appbtab3" class="figpopup">Table 7. Last searched on 22 March 2018</a></p></div></div><div id="chb3.appc"><h3>Appendix C. Clinical evidence study selection</h3><p>Clinical evidence study selection for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><p id="chb3.appc.fig1"><a href="/books/NBK578090/figure/chb3.appc.fig1/?report=objectonly" target="object" rid-ob="figobchb3appcfig1" class="figpopup">Figure 1. Flow diagram of clinical article selection for review on assessment and monitoring of feeding and maintaining nutrition</a></p></div><div id="chb3.appd"><h3>Appendix D. Clinical evidence tables</h3><p>Clinical evidence tables for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><p id="chb3.appd.et1"><a href="/books/NBK578090/bin/chb3-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 8. Studies included in the evidence review for assessment and monitoring of feeding and nutritional problems</a><span class="small"> (PDF, 309K)</span></p></div><div id="chb3.appe"><h3>Appendix E. Forest plots</h3><p>Forest plots for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><div id="chb3.appe.s1"><h4>Screening tools</h4><p id="chb3.appe.fig1"><a href="/books/NBK578090/figure/chb3.appe.fig1/?report=objectonly" target="object" rid-ob="figobchb3appefig1" class="figpopup">Figure 2. Forest plot of MST-CP (threshold score = 0 points - low risk) in screening for risk of malnutrition in adults with CP</a></p><p id="chb3.appe.fig2"><a href="/books/NBK578090/figure/chb3.appe.fig2/?report=objectonly" target="object" rid-ob="figobchb3appefig2" class="figpopup">Figure 3. Forest plot of MST-CP (threshold score < 10 points - high risk) in screening for risk of malnutrition in adults with CP</a></p></div></div><div id="chb3.appf"><h3>Appendix F. GRADE tables</h3><p>GRADE tables for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><p id="chb3.appf.et1"><a href="/books/NBK578090/bin/chb3-appf-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 9. Clinical evidence profile: MST-CP (at thresholds of 0 and 10) to differentiate between high risk and low risk of malnutrition in adults with cerebral palsy</a><span class="small"> (PDF, 241K)</span></p></div><div id="chb3.appg"><h3>Appendix G. Economic evidence study selection</h3><p>Economic evidence study selection for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><p>No economic evidence was identified for this review.</p></div><div id="chb3.apph"><h3>Appendix H. Economic evidence tables</h3><p>Economic evidence tables for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><p>No economic evidence was identified for this review.</p></div><div id="chb3.appi"><h3>Appendix I. Health economic evidence profiles</h3><p>Health economic evidence profiles for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><p>No economic evidence was identified for this review.</p></div><div id="chb3.appj"><h3>Appendix J. Health economic analysis</h3><p>Health economic analysis for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><p>No economic analysis was included in this review.</p></div><div id="chb3.appk"><h3>Appendix K. Excluded studies</h3><p>Clinical and economic lists of excluded studies for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><div id="chb3.appk.s1"><h4>Clinical studies</h4><p id="chb3.appk.et1"><a href="/books/NBK578090/bin/chb3-appk-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 10. Clinical studies for monitoring feeding and nutritional problems</a><span class="small"> (PDF, 200K)</span></p></div><div id="chb3.appk.s2"><h4>Economic studies</h4><p>No economic evidence was identified for this review.</p></div></div><div id="chb3.appl"><h3>Appendix L. Research recommendations</h3><p>Research recommendations for review question B3: What is the best way to assess and monitor the safety (of swallowing and risk of aspiration) and effectiveness of feeding and maintaining nutrition in adults with cerebral palsy?</p><p>No research recommendation was made for this review.</p></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews</p><p>These evidence reviews were developed by the National Guideline Alliance, hosted by the Royal College of Obstetricians and Gynaecologists</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div><div class="small"><span class="label">Bookshelf ID: NBK578090</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/35192274" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">35192274</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobchb3tab1"><div id="chb3.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of the protocol (PICO/PIRO table)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578090/table/chb3.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chb3.tab1_lrgtbl__"><table class="no_bottom_margin"><tbody><tr><th id="hd_b_chb3.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><td headers="hd_b_chb3.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults aged 25 and over with cerebral palsy and with suspected feeding and nutritional problems (at least 50% of study participants). For diagnostic questions include intake/sample/setting of people to be tested.</td></tr><tr><th id="hd_b_chb3.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention / index test</th><td headers="hd_b_chb3.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Monitoring protocol for feeding and nutritional problems involving any of the following:
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<ul id="l189"><li id="lt579" class="half_rhythm"><div>Dietary assessment, including gastrointestinal issues such as:
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<ul id="l190" class="circle"><li id="lt580" class="half_rhythm"><div>dysphagia</div></li><li id="lt581" class="half_rhythm"><div>fore gut dysmotility</div></li><li id="lt582" class="half_rhythm"><div>hind gut dysmotility</div></li></ul></div></li><li id="lt583" class="half_rhythm"><div>Clinical assessment</div></li><li id="lt584" class="half_rhythm"><div>Anthropometric assessment
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<ul id="l191" class="circle"><li id="lt585" class="half_rhythm"><div>BMI</div></li><li id="lt586" class="half_rhythm"><div>Fat measure</div></li><li id="lt587" class="half_rhythm"><div>skinfold measurement</div></li></ul></div></li><li id="lt588" class="half_rhythm"><div>Screening tools
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<ul id="l192" class="circle"><li id="lt589" class="half_rhythm"><div>MUST</div></li></ul></div></li></ul>
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</td></tr><tr><th id="hd_b_chb3.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison / reference standard</th><td headers="hd_b_chb3.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Any other monitoring protocol</td></tr><tr><th id="hd_b_chb3.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</th><td headers="hd_b_chb3.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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<ul id="l193"><li id="lt590" class="half_rhythm"><div>Function</div></li><li id="lt591" class="half_rhythm"><div>HR-QoL</div></li><li id="lt592" class="half_rhythm"><div>Chest infection</div></li></ul>
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<b>Important</b>
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<ul id="l194"><li id="lt593" class="half_rhythm"><div>Patient satisfaction</div></li><li id="lt594" class="half_rhythm"><div>Mortality</div></li><li id="lt595" class="half_rhythm"><div>Weight</div></li><li id="lt596" class="half_rhythm"><div>Skin integrity</div></li><li id="lt597" class="half_rhythm"><div>Feeding time</div></li><li id="lt598" class="half_rhythm"><div>TOMS – swallowing outcome</div></li></ul>
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<i>In the absence of test and treat studies<sup>1</sup>:</i>
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<ul id="l195"><li id="lt599" class="half_rhythm"><div>Diagnostic accuracy:
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<ul id="l196" class="circle"><li id="lt600" class="half_rhythm"><div>Sensitivity</div></li><li id="lt601" class="half_rhythm"><div>Specificity</div></li><li id="lt602" class="half_rhythm"><div>Positive/Negative likelihood ratios</div></li></ul></div></li></ul>
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</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">BMI: Body Mass Index; HR-Qol: Health-Related Quality of Life; MUST: Malnutrition Universal Screening Tool; TOMS: Therapy Outcome Measures-Swallowing.</p></div></dd></dl><dl class="bkr_refwrap"><dt>1</dt><dd><div id="chb3.tab1_1"><p class="no_margin">The review question was framed as an intervention review but in the absence of test and treat studies diagnostic accuracy studies would be included, with the assumption that accurate identification of feeding problems is likely to improve outcomes.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobchb3tab2"><div id="chb3.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of included studies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578090/table/chb3.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chb3.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_chb3.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_chb3.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Design</th><th id="hd_h_chb3.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Participants</th><th id="hd_h_chb3.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Index test</th><th id="hd_h_chb3.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reference standard</th><th id="hd_h_chb3.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_chb3.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<a class="bibr" href="#chb3.s1.ref1" rid="chb3.s1.ref1">Benigni 2011</a>
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</td><td headers="hd_h_chb3.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Prospective observational study</td><td headers="hd_h_chb3.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=365, mean age 36 years.</p>
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<p>France</p>
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</td><td headers="hd_h_chb3.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="l197"><li id="lt603" class="half_rhythm"><div>Malnutrition screening tool for adults with CP (MST-CP)</div></li></ul></td><td headers="hd_h_chb3.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Composite based on:
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<ul id="l198"><li id="lt604" class="half_rhythm"><div>weight loss from usual body weight</div></li><li id="lt605" class="half_rhythm"><div>BMI</div></li><li id="lt606" class="half_rhythm"><div>albuminuria</div></li></ul></td><td headers="hd_h_chb3.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Weight (malnutrition)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">BMI: Body Mass Index; CP: Cerebral Palsy; MST-CP: Malnutrition Screening Tool for Cerebral Palsy; N: number of participants in study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobchb3tab3"><div id="chb3.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Summary of clinical evidence of MST-CP (at thresholds of 0 and 10) to differentiate between high risk and low risk of malnutrition in adults with cerebral palsy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578090/table/chb3.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chb3.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_chb3.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_chb3.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">N</th><th id="hd_h_chb3.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk of bias<sup>1</sup></th><th id="hd_h_chb3.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Screening score<sup>2</sup></th><th id="hd_h_chb3.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Inconsistency</th><th id="hd_h_chb3.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Indirectness<sup>3</sup></th><th id="hd_h_chb3.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Imprecision<sup>4</sup></th><th id="hd_h_chb3.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Sensitivity (95% CI)</th><th id="hd_h_chb3.tab3_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Specificity (95% CI)</th><th id="hd_h_chb3.tab3_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Positive likelihood ratio<sup>5</sup></th><th id="hd_h_chb3.tab3_1_1_1_11" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Negative likelihood ratio<sup>5</sup></th><th id="hd_h_chb3.tab3_1_1_1_12" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_chb3.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 observational study</td><td headers="hd_h_chb3.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">365</td><td headers="hd_h_chb3.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>6</sup></td><td headers="hd_h_chb3.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">score=0<sup>2</sup></td><td headers="hd_h_chb3.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not applicable</td><td headers="hd_h_chb3.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_chb3.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>7</sup></td><td headers="hd_h_chb3.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>0.78</p>
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<p>(0.72 - 0.84)</p>
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</td><td headers="hd_h_chb3.tab3_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>0.51</p>
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<p>(0.43–0.60)</p>
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</td><td headers="hd_h_chb3.tab3_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.60</td><td headers="hd_h_chb3.tab3_1_1_1_11" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0.42</td><td headers="hd_h_chb3.tab3_1_1_1_12" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_chb3.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 observational study</td><td headers="hd_h_chb3.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">365</td><td headers="hd_h_chb3.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious<sup>6</sup></td><td headers="hd_h_chb3.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">score>10<sup>2</sup></td><td headers="hd_h_chb3.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not applicable</td><td headers="hd_h_chb3.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not serious</td><td headers="hd_h_chb3.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious</td><td headers="hd_h_chb3.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>0.55</p>
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<p>(0.44–0.66)</p>
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</td><td headers="hd_h_chb3.tab3_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>0.87</p>
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<p>(0.82–0.90)</p>
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</td><td headers="hd_h_chb3.tab3_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.24</td><td headers="hd_h_chb3.tab3_1_1_1_11" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0.51</td><td headers="hd_h_chb3.tab3_1_1_1_12" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moderate</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">CI: confidence interval; CP: cerebral Palsy; MST-CP: malnutrition screening tool for cerebral palsy; N: number of participants in study</p></div></dd></dl><dl class="bkr_refwrap"><dt>1</dt><dd><div id="chb3.tab3_1"><p class="no_margin">Risk of bias evaluated using risk of bias items of QUADAS-2 checklist.</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="chb3.tab3_2"><p class="no_margin">Index screening test – model based on the following variables: 1) body weight < 40 kg (10 points); 2) uncomfortable or impossible sitting position (4 points); 3) partial or total help needed for eating (4 points) and 4) suspicion of gastro-oesophageal reflux (3 points). The highest score possible was 21 points: A score higher than 10 points indicated high risk (severe malnutrition). A score higher than 0 and less than 10 points indicated mild risk (moderate malnutrition). A score equal to 0 indicated low risk (no malnutrition).</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="chb3.tab3_3"><p class="no_margin">Indirectness was evaluated using the applicability items of QUADAS-2.</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="chb3.tab3_4"><p class="no_margin">Judgement of imprecision was based on consideration of the 95% CIs of test sensitivity as this was considered to be the primary measure of interest as a false negative - missing malnourished patients, whilst a false positive - indicating risks of malnutrition when there is none. Studies were considered to be of high sensitivity (and not imprecise) if the 95% CI was above 0.9 or of low sensitivity if it was below 0.75. Studies were assessed as subject to serious imprecision if the 95% CI crossed either 0.75 or 0.9, or subject to very serious imprecision if it crossed both 0.75 and 0.9.</p></div></dd></dl><dl class="bkr_refwrap"><dt>5</dt><dd><div id="chb3.tab3_5"><p class="no_margin">Positive and negative likelihood ratios calculated from sensitivity and specificity estimates.</p></div></dd></dl><dl class="bkr_refwrap"><dt>6</dt><dd><div id="chb3.tab3_6"><p class="no_margin">Unclear risk of review bias (lack of blinding in the interpretation both of the index test and reference standard – no details are given in the text) and patient selection; with flow and timing of patient unclear</p></div></dd></dl><dl class="bkr_refwrap"><dt>7</dt><dd><div id="chb3.tab3_7"><p class="no_margin">95% CI for sensitivity crosses 0.75.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobchb3appbtab1"><div id="chb3.appb.tab1" class="table"><h3><span class="label">Table 5</span><span class="title">Last search on 22 March 2018</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578090/table/chb3.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chb3.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#</th><th id="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Cerebral Palsy/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp cerebral palsy/ use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((cerebral or brain or central) adj2 (pal* or paralys#s or pares#s)).tw.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cerebral palsy.ti,ab.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">little? disease.tw.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((hemipleg* or dipleg* or tripleg* or quadripleg* or unilateral*) adj5 spastic*).tw.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((hemipleg* or dipleg* or tripleg* or quadripleg* or unilateral*) adj3 ataxi*).tw.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1–6</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 8 to english language</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 9 to (adult <18 to 64 years> or aged <65+ years>) use oemezd [Limit not valid in Ovid MEDLINE(R),Ovid MEDLINE(R) In-Process; records were retained]</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 9 to “all adult (19 plus years)” [Limit not valid in Embase; records were retained]</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11 use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/10,12</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Nutrition Policy/ or exp Nutrition Disorders/ or exp Nutrition Assessment/ or exp Nutrition Therapy/ or exp “Feeding and Eating Disorders”/ or exp Feeding Behavior/ or exp Diet/ or exp Deglutition Disorders/ or exp Gastrointestinal Motility/ or exp Esophageal Motility Disorders/ or exp Dyspepsia/ or exp Constipation/ or exp Gastroesophageal Reflux/ or exp Obesity/ or exp Anthropometry/ or exp Overweight/ or exp Body Composition/ or exp Body Weight/ or exp Nutritional Status/ or exp Body Mass Index/ or exp Skinfold Thickness/ or exp Deglutition/ or exp Respiratory Aspiration/ or exp Drinking/ or exp Eating/ or exp Mastication/ or exp Diet, Reducing/ or exp Weight Loss/ or exp Calorimetry, Indirect/ or exp Waist Circumference/ or exp Energy Intake/ or exp Nutritional Requirements/ or exp Malnutrition/ or exp Dietary Supplements/ or exp Nutritional Support/ or exp Food, Fortified/ or exp Protein-Energy Malnutrition/ or exp Metabolism/ or exp Basal Metabolism/ or exp Digestion/ or exp Enteral Nutrition/ or exp “Cooking and Eating Utensils”/ or exp Equipment Design/ or exp Meals/ or exp Gastric Emptying/ or exp Gastrostomy/ or exp Jejunostomy/ or exp Feeding Methods/ or exp “Task Performance and Analysis”/ or exp Biomechanical Phenomena/ or exp Human Engineering/ or exp “Activities of Daily Living”/ or exp Self Care/ or exp airway obstruction/</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Disability Evaluation/ or exp Disease Progression/ or exp “Severity of Illness Index”/</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14 or 15 use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp nutritional health/ or exp diet/ or exp nutrition policy/ or exp food/ or exp nutrition/ or exp obesity/ or exp nutritional disorder/ or exp nutritional assessment/ or exp diet therapy/ or exp eating disorder/ or exp feeding behavior/ or exp dysphagia/ or exp swallowing/ or exp gastrointestinal motility/ or exp esophagus function disorder/ or exp dyspepsia/ or exp constipation/ or exp gastroesophageal reflux/ or exp anthropometry/ or exp body composition/ or exp body weight/ or exp nutritional status/ or exp body mass/ or exp skinfold thickness/ or exp skinfold/ or exp acid aspiration/ or exp drinking/ or exp eating/ or exp eating habit/ or exp mastication/ or exp low calory diet/ or exp weight reduction/ or exp indirect calorimetry/ or exp waist circumference/ or exp body fat/ or exp caloric intake/ or exp nutritional requirement/ or exp protein calorie malnutrition/ or exp malnutrition/ or exp dietary supplement/ or exp nutritional support/ or exp metabolism/ or exp fortified food/ or exp basal metabolic rate/ or exp digestion/ or exp enteric feeding/ or exp kitchen/ or exp equipment design/ or exp meal/ or exp stomach emptying/ or exp gastrostomy/ or exp jejunostomy/ or exp food intake/ or exp bioengineering/ or exp ergonomics/ or exp motion analysis system/ or exp task performance/ or exp daily life activity/ or exp self help/ or exp feeding apparatus/ or exp airway obstruction/</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp disability/ or exp disease course/ or exp “severity of illness index”/</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17 or 18 use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(“Eating and Drinking Ability Classification System” or EDACS or “Fatigue Impact and Severity Self-Assessment” or FISSA or “Mann Assessment of Swallowing Ability” or MASA or “Functional Dysphagia Scale” or FDS).ti,ab.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((problem* or difficult* or safe*) adj2 (feeding or eat* or drink* or chew* or metabol* or nutrition* or swallow* or aspiration)).ti,ab.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(nutriti* or feed* or eat* or drink* or biting or choke* or choking or cough* or gagging or gag* or vomit* or meal* or energy or chew* or digest* or metabolism* or swallow* or diet* or deglut* or motilit* or dyspeps* or constipat* or reflux or dysphag* or obes* or weigh* or overweigh* or underweigh* or anthropometr* or malnutri* or aspirat*).ti,ab.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(nutrition* adj (supplement* or optim* or deficient* or support* or require*)).ti,ab.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((skin?fold* or fat or body or weight or bowel) adj (measure* or protocol* or assess* or monitor* or screen* or safe* or scale* or symptom* or dysfunction*)) or BMI or calorimetry).ti,ab.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(body composition or waist circumference).ti,ab.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16 or 19 or 20 or 21 or 22 or 23 or 24 or 25</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13 and 26</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">conference abstract.pt. use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or LETTER/ use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Letter/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">EDITORIAL/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt. use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NEWS/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp HISTORICAL ARTICLE/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt. use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANECDOTES AS TOPIC/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">COMMENT/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CASE REPORT/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CASE REPORT/ use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CASE STUDY/ use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment* or abstracts).ti.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/28–41</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RANDOMIZED CONTROLLED TRIAL/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RANDOMIZED CONTROLLED TRIAL/ use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">random*.ti,ab.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/43–45</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42 not 46</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANIMALS/ not HUMANS/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANIMAL/ not HUMAN/ use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp ANIMALS, LABORATORY/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp ANIMAL EXPERIMENTATION/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp MODELS, ANIMAL/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp RODENTIA/ use prmz</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NONHUMAN/ use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp ANIMAL EXPERIMENT/ use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp EXPERIMENTAL ANIMAL/ use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANIMAL MODEL/ use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp RODENT/ use oemezd</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/47–59</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27 not 60</td></tr><tr><td headers="hd_h_chb3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62</td><td headers="hd_h_chb3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 61 to yr=“1990 -Current”</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobchb3appbtab2"><div id="chb3.appb.tab2" class="table"><h3><span class="label">Table 6</span><span class="title">Last searched on 22 March 2018</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578090/table/chb3.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chb3.appb.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">ID</th><th id="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Search</th></tr></thead><tbody><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Cerebral Palsy] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((cerebral or brain or central) N2 (pal* or paralys?s or pare?s))</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((hemipleg* or dipleg* or tripleg* or quadripleg* or unilateral*) N5 spastic*)</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((hemipleg* or dipleg* or tripleg* or quadripleg* or unilateral*) N3 ataxi*)</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 or #2 or #3 or #4</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Nutrition Policy] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Nutrition Disorders] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Nutrition Assessment] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Nutrition Therapy] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Feeding and Eating Disorders] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Feeding Behavior] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Diet] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Deglutition Disorders] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Gastrointestinal Motility] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Esophageal Motility Disorders] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#16</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Dyspepsia] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#17</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Constipation] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Gastroesophageal Reflux] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Obesity] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Anthropometry] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#21</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Overweight] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#22</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Body Composition] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#23</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Body Weight] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#24</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Nutritional Status] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#25</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Body Mass Index] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#26</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Skinfold Thickness] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#27</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Deglutition] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#28</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Respiratory Aspiration] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#29</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Drinking] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#30</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Eating] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#31</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Mastication] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#32</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Diet, Reducing] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#33</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Diet Therapy] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#34</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Fat Body] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#35</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Weight Loss] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#36</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Weight Gain] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#37</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Calorimetry, Indirect] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#38</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Waist Circumference] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#39</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Energy Intake] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#40</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Nutritional Requirements] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#41</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Malnutrition] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#42</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Dietary Supplements] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#43</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Nutritional Support] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#44</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Food, Fortified] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#45</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Protein-Energy Malnutrition] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#46</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Metabolism] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#47</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Basal Metabolism] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#48</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Digestion] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#49</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Disability Evaluation] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#50</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Disease Progression] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#51</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Severity of Illness Index] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#52</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">“Eating and Drinking Ability Classification System” or EDACS or “Fatigue Impact and Severity Self-Assessment” or FISSA or “Mann Assessment of Swallowing Ability” or MASA or “Functional Dysphagia Scale” or FDS</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#53</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nutrition* or feed* or eat* or drink* or biting or energy or chew* or digest* or metabolism* or swallow* or diet* or deglut* or motilit* or dyspeps* or constipat* or reflux or dysphag* or obes* or weigh* or overweigh* or underweigh* or anthropometr* or malnutri* or aspirat* or body composition or waist circumference or skin?fold* or fat or body or weight or bowel or BMI or calorimetry or supplement or anthropometry or choke* or choking or cough* or gagging or gag* or vomit*</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#54</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">oral appliance* or oral sensorimotor skill* or utensil* or equipment or meal* or gastrostomy* or Jejunostom* or enteral nutrition*</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#55</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Cooking and Eating Utensils] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#56</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Equipment Design] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#57</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Meals] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#58</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Gastric Emptying] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#59</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Enteral Nutrition] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#60</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Gastrostomy] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#61</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Jejunostomy] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#62</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Feeding Methods] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#63</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Task Performance and Analysis] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#64</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Biomechanical Phenomena] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#65</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Human Engineering] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#66</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Activities of Daily Living] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#67</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Self Care] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#68</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Airway Obstruction] explode all trees</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#69</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">{or #6–#68}</td></tr><tr><td headers="hd_h_chb3.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#70</td><td headers="hd_h_chb3.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5 and #69</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobchb3appbtab3"><div id="chb3.appb.tab3" class="table"><h3><span class="label">Table 7</span><span class="title">Last searched on 22 March 2018</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578090/table/chb3.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chb3.appb.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_chb3.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Set</th><th id="hd_h_chb3.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Search</th></tr></thead><tbody><tr><td headers="hd_h_chb3.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>#3</b>
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</td><td headers="hd_h_chb3.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>#2 AND #1</p>
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<p>1990–2017 AND LANGUAGE: (English)</p>
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</td></tr><tr><td headers="hd_h_chb3.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>#2</b>
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</td><td headers="hd_h_chb3.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(ts=nutrition or ts=feed* or ts=swallow* or ts=aspiration or ts=food or ts=eat* or ts=drink* or ts=bit* or ts=chew* or ts=digest* or ts=choke* or ts=choking or ts=cough* or ts=gagging or ts=gag* or ts=vomit* or ts=airway obstruct*)</td></tr><tr><td headers="hd_h_chb3.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>#1</b>
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</td><td headers="hd_h_chb3.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ts=Cerebral Palsy</td></tr></tbody></table></div></div></article><article data-type="fig" id="figobchb3appcfig1"><div id="chb3.appc.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20Flow%20diagram%20of%20clinical%20article%20selection%20for%20review%20on%20assessment%20and%20monitoring%20of%20feeding%20and%20maintaining%20nutrition.&p=BOOKS&id=578090_chb3appcf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK578090/bin/chb3appcf1.jpg" alt="Figure 1. Flow diagram of clinical article selection for review on assessment and monitoring of feeding and maintaining nutrition." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">Flow diagram of clinical article selection for review on assessment and monitoring of feeding and maintaining nutrition</span></h3></div></article><article data-type="fig" id="figobchb3appefig1"><div id="chb3.appe.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%202.%20Forest%20plot%20of%20MST-CP%20(threshold%20score%20%3D%200%20points%20-%20low%20risk)%20in%20screening%20for%20risk%20of%20malnutrition%20in%20adults%20with%20CP.&p=BOOKS&id=578090_chb3appef1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK578090/bin/chb3appef1.jpg" alt="Figure 2. Forest plot of MST-CP (threshold score = 0 points - low risk) in screening for risk of malnutrition in adults with CP." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">Forest plot of MST-CP (threshold score = 0 points - low risk) in screening for risk of malnutrition in adults with CP</span></h3><div class="caption"><p>CI: confidence interval; FN: false negative; FP: false positive; MST-CP: malnutrition screening tool for cerebral palsy; TN: true negative; TP: true positive</p></div></div></article><article data-type="fig" id="figobchb3appefig2"><div id="chb3.appe.fig2" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%203.%20Forest%20plot%20of%20MST-CP%20(threshold%20score%20%3C%2010%20points%20-%20high%20risk)%20in%20screening%20for%20risk%20of%20malnutrition%20in%20adults%20with%20CP.&p=BOOKS&id=578090_chb3appef2.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK578090/bin/chb3appef2.jpg" alt="Figure 3. Forest plot of MST-CP (threshold score < 10 points - high risk) in screening for risk of malnutrition in adults with CP." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 3</span><span class="title">Forest plot of MST-CP (threshold score < 10 points - high risk) in screening for risk of malnutrition in adults with CP</span></h3><div class="caption"><p>CI: confidence interval; FN: false negative; FP: false positive; MST-CP: malnutrition screening tool for cerebral palsy; TN: true negative; TP: true positive</p></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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