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The reliability and validity of the upper lip bite test compared with the Mallampati classification to predict difficult laryngoscopy: an external prospective evaluation.
Anesth Analg. 2005 Jul; 101(1):284-9, table of contents.A&A

Abstract

Recently, a new bedside screening test to predict the occurrence of a difficult laryngoscopy has been developed as a substitute for the Mallampati classification. The Upper-Lip-Bite test (ULBT) evaluated the patient's ability to reach or completely cover the upper lip with the lower incisors. It is often accepted that new predictive tools should undergo an external evaluation before the tool is used in clinical practice. Thus, we evaluated this test with respect to applicability, interobserver reliability, and discriminating power and compared it with the Mallampati-score (using Samsoon and Young's modification). The ULBT could not be applied in 12% of all patients (Mallampati score, <1%). However, the interobserver reliability was better for the ULBT (kappa = 0.79 versus kappa = 0.59). The discriminating power to predict a patient with difficult laryngoscopy was evaluated in 1425 consecutive patients. Both tests were assessed simultaneously in these patients by two specially trained independent observers. After the induction of anesthesia, the laryngoscopic view was assessed by the attending anesthesiologist using the classification of Cormack and Lehane. A grade I or II was called easy laryngoscopy and grade III and IV difficult laryngoscopy. The discriminating power for both tests was low (0.60 for the ULBT [95% confidence interval, 0.57-0.63] and 0.66 [0.63-0.69]) for the Mallampati score), indicating that both tests are poor predictors as single screening tests.

Authors+Show Affiliations

Department of Anesthesiology and Critical Care Medicine, Philipps-University Marburg, Baldingerstrasse 1, 35043 Marburg, Germany. eberhart@mailer.uni-marburg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

15976247

Citation

Eberhart, Leopold H J., et al. "The Reliability and Validity of the Upper Lip Bite Test Compared With the Mallampati Classification to Predict Difficult Laryngoscopy: an External Prospective Evaluation." Anesthesia and Analgesia, vol. 101, no. 1, 2005, 284-9, table of contents.
Eberhart LH, Arndt C, Cierpka T, et al. The reliability and validity of the upper lip bite test compared with the Mallampati classification to predict difficult laryngoscopy: an external prospective evaluation. Anesth Analg. 2005;101(1):284-9, table of contents.
Eberhart, L. H., Arndt, C., Cierpka, T., Schwanekamp, J., Wulf, H., & Putzke, C. (2005). The reliability and validity of the upper lip bite test compared with the Mallampati classification to predict difficult laryngoscopy: an external prospective evaluation. Anesthesia and Analgesia, 101(1), 284-9, table of contents.
Eberhart LH, et al. The Reliability and Validity of the Upper Lip Bite Test Compared With the Mallampati Classification to Predict Difficult Laryngoscopy: an External Prospective Evaluation. Anesth Analg. 2005;101(1):284-9, table of contents. PubMed PMID: 15976247.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The reliability and validity of the upper lip bite test compared with the Mallampati classification to predict difficult laryngoscopy: an external prospective evaluation. AU - Eberhart,Leopold H J, AU - Arndt,Christian, AU - Cierpka,Thomas, AU - Schwanekamp,Judith, AU - Wulf,Hinnerk, AU - Putzke,Caroline, PY - 2005/6/25/pubmed PY - 2005/7/13/medline PY - 2005/6/25/entrez SP - 284-9, table of contents JF - Anesthesia and analgesia JO - Anesth Analg VL - 101 IS - 1 N2 - Recently, a new bedside screening test to predict the occurrence of a difficult laryngoscopy has been developed as a substitute for the Mallampati classification. The Upper-Lip-Bite test (ULBT) evaluated the patient's ability to reach or completely cover the upper lip with the lower incisors. It is often accepted that new predictive tools should undergo an external evaluation before the tool is used in clinical practice. Thus, we evaluated this test with respect to applicability, interobserver reliability, and discriminating power and compared it with the Mallampati-score (using Samsoon and Young's modification). The ULBT could not be applied in 12% of all patients (Mallampati score, <1%). However, the interobserver reliability was better for the ULBT (kappa = 0.79 versus kappa = 0.59). The discriminating power to predict a patient with difficult laryngoscopy was evaluated in 1425 consecutive patients. Both tests were assessed simultaneously in these patients by two specially trained independent observers. After the induction of anesthesia, the laryngoscopic view was assessed by the attending anesthesiologist using the classification of Cormack and Lehane. A grade I or II was called easy laryngoscopy and grade III and IV difficult laryngoscopy. The discriminating power for both tests was low (0.60 for the ULBT [95% confidence interval, 0.57-0.63] and 0.66 [0.63-0.69]) for the Mallampati score), indicating that both tests are poor predictors as single screening tests. SN - 0003-2999 UR - https://www.unboundmedicine.com/medline/citation/15976247/The_reliability_and_validity_of_the_upper_lip_bite_test_compared_with_the_Mallampati_classification_to_predict_difficult_laryngoscopy:_an_external_prospective_evaluation_ L2 - https://doi.org/10.1213/01.ANE.0000154535.33429.36 DB - PRIME DP - Unbound Medicine ER -