ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Imaging Comparison Of Sjogrens Syndrome
Clinical Question In a patient with Sjogrens Syndrome (SS) does ultrasound imaging (US) give you comparable diagnostic information as received with sialography.
Clinical Bottom Line Ultrasound imaging gives comparable results as diagnostic information received from sialography, especially when evaluating submandibular glands.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20498211Takagi/2010360 patients (188 with SS and 172 non-SS)Clinical Comparative Study
Key results"The kappa value for intermodality agreement between sialography and parotid ultrasonography was 0.81 and between sialography and submandibular ultrasound was 0.76, indicating very good and good agreement, respectively. The diagnostic ability of parotid ultrasound was significantly lower than that of sialography (p<0.001, McNemar test). However, the diagnostic ability of submandibular ultrasound was comparable to that of sialography (p=0.153)." Takagi 2010
#2) 20123387Obinata/201073 PatientsClinincal Comparative Study
Key results"There was a statistically significant difference in the sensitivities of sialography and histopathology, in the specificities of sialography and ultrasonography, and in the accuracies of sialography and both ultrasonography and histopathology. The correlation coefficient (r) between sialography and ultrasonography was significantly higher than the others and indicated a good correlation." Obinata 2010
Evidence Search Sjogrens Syndrome AND ultrasound AND sialography ...view in PubMed
Comments on
The Evidence
In both studies clinical comparisons were made on patients that were pre-selected as having Sjogrens Syndrome (SS) or suspected having SS. In both studies observers were unaware of the results of the prior test taken, which allowed for a less biased results for comparing sialography and sonography.
Applicability Sjogrens Syndrome cannot be characterized by a single “gold standard” test therefore it takes a combination of criteria for a diagnosis. Due to this, some patients are not easily diagnosed. When salivary gland assessment is deemed necessary by the clinician, ultrasonography compares favorably to sialography in terms of diagnostic accuracy. Ultrasound has the advantage of being low cost, less invasive, and provides no radiation exposure.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry)
Keywords Ultrasound, Sjogrens Syndrome, sialography
ID# 840
Date of submission: 04/01/2011spacer Revised: 01/23/2012
E-mail cowlingj@livemail.uthscsa.edu
Author Jefferson Cowling
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Michaell A. Huber, DDS
Faculty mentor/Co-author e-mail HuberM@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Priscilla Leary and Thomas Adams (San Antonio) on 11/29/2017
A PubMed search was performed in November 2017 for ultrasound, sialography and Sjogren's Syndrome. This search yielded multiple results including a meta-analysis by Song et al 2014(2015) (PMID 25005026) which concludes that ultrasound and sialography provide comparable results. However, the Schafer et al article from 2017 (PMID 28447158) indicates that ultrasound in diagnosing Sjogren's Syndrome is easier, faster, non-invasive and inexpensive. Two additional articles support Schafer’s conclusions: Saied et al. 2013 (PMID 26675053), Parada-Turska 2016 (PMID 27941210) Clinicians are encouraged to consider all aspects of this evidence and discuss options with patients in need of diagnostics regarding Sjogren’s. Overall, this evidence supports the clinical bottom line that both tools are comparable in aiding the diagnosis of Sjogren’s, however when considering patient comfort, clinical time and expense, ultrasound appears ,based on current literature, to be a better choice.
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