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Artificial intelligence tools for the assessment and management of dysphagia: protocol for a scoping review

Por: Sreedevi · E. V. · Iyer K · S. · Thankappan · K. · Janakiram · C. · Karuveettil · V. · Krishnan · R. · Guntha · R. · Roe · J. · Menon · J. R.
Introduction

Dysphagia, or difficulty in swallowing, significantly impacts the quality of life of the affected individuals. Diagnostic approaches, including video fluoroscopic swallowing studies and flexible endoscopic evaluation of swallowing, are the most commonly used methods for assessing swallowing function. Recent advancements have led to the development of artificial intelligence (AI), including machine learning (ML) and deep learning (DL), which will provide innovative approaches to dysphagia diagnosis and treatment planning. There is a limited synthesis of literature on AI tools in dysphagia. There is an urgent need for a more rigorous and structured scoping review that can address the existing gaps, provide a more comprehensive evidence synthesis, and establish clearer guidelines for the clinical implementation of AI in assessments and management of dysphagia. This review will include studies focusing on AI tools such as ML, DL and computer vision for assessing and managing dysphagia. The context will be clinical or therapeutic settings, and all language articles will be considered for the review. Studies not involving AI technologies, those without clinical outcomes and ethical approval, and those focusing solely on the paediatric population will be excluded. This scoping review will systematically map and synthesise the existing literature on the use of AI tools for the assessment and management of dysphagia.

Methods and analysis

This scoping review will follow JBI methodology and PRISMA ScR guidelines. Information to be searched from January 2000 to May 2025 will include MEDLINE (via Ovid), Scopus, CINAHL (via EBSCOhost), Cochrane Library, JBI Evidence Synthesis, ProQuest and Google Scholar. The titles, abstracts and full texts will be screened by two independent reviewers. Data extraction will use a study-specific customised form, with descriptive analysis employed to categorise studies by AI tools and outcomes.

Ethics and dissemination

Ethical approval is not mandatory for this scoping review as it does not entail the collection of any individual patient data. Secondary data from publicly accessible research papers will be used. All the data sources will be appropriately cited. The findings will be propagated through peer-reviewed publications and scientific presentations.

Trial registration number

Open Science Framework: DOI 10.17605/OSF.IO/DYCE9.

Assessing health system preparedness from trends and time delays in the management of myocardial infarctions during the COVID-19 pandemic in India: a multicentre retrospective cohort study

Por: Menon · J. C. · MS · A. · S · H. · Janakiram · C. · James · A. · Sreedevi · A. · Menon · G. R. · John · D. · Cherian · J. J. · V · V. · Abhaichand · R. K. · Punnoose · E. P. · BS · A. · Abraham · M. · Thomas · P. · Pedada · C. · Govindan · U. · Mohan · B. · Pisharody · S. · Devasia · T. · Seba
Objectives

This study aimed to analyse the number of myocardial infarction (MI) admissions during the COVID-19 lockdown periods of 2020 and 2021 (March 15th to June 15th) and compare them with corresponding pre-pandemic period in 2019. The study also evaluated changes in critical treatment intervals: onset to door (O2D), door to balloon (D2B) and door to needle (D2N) and assessed 30-day clinical outcomes. This study examined MI care trends in India during the COVID-19 lockdown period, irrespective of patients’ COVID-19 infection status.

Design

Multicentre retrospective cohort study

Setting

Twenty-three public and private hospitals across multiple Indian states, all with 24/7 interventional cardiology facilities.

Participants

All adults (>18 years) admitted with acute myocardial infarction between March 15 and June 15 in 2019 (pre-pandemic), 2020 (first lockdown) and 2021 (second lockdown). A total of 3614 cases were analysed after excluding duplicates and incomplete data.

Primary outcomes

Number of MI admissions, median O2D, D2B and D2N times.

Secondary outcomes

30-day outcomes including death, reinfarction and revascularisation.

Results

MI admissions dropped from 4470 in year 2019 to 2131 (2020) and 1483 (2021). The median O2D increased from 200 min (IQR 115–428) pre-COVID-19 to 390 min (IQR 165–796) in 2020 and 304 min (IQR 135–780) in 2021. The median D2B time reduced from 225 min (IQR 120–420) in 2019 to 100 min (IQR 53–510) in 2020 and 130 min (IQR 60–704) in 2021. Similarly, D2N time decreased from 240 min (IQR 120–840) to 35 min (IQR 25–69) and 45 min (IQR 24–75), respectively. The 30-day outcome of death, reinfarction and revascularisation was 4.25% in 2020 and 5.1% in 2021, comparable to 5.8% reported in the Acute Coronary Syndrome Quality Improvement in Kerala study.

Conclusion

Despite the expansion of catheterisation facilities across India, the country continues to fall short of achieving international benchmarks for optimal MI care.

Economic burden and economic impact of oral diseases in India: a protocol for a systematic review

Por: Karuveettil · V. · Janakiram · C. · Ramesh · S. · Ramachandran · A. · John · D.
Introduction

Oral diseases are a major contributor to global disability but remain largely neglected in health policy, especially in low- and middle-income countries. India carries a disproportionately high burden of dental caries and periodontal disease, with limited access to oral healthcare and high reliance on out-of-pocket expenditure (OOPE). Despite this, there is a lack of synthesised economic evidence specific to India, which limits informed policymaking and resource allocation. This systematic review aims to assess the economic burden and financial impact of oral diseases in India—at individual, household, health system and societal levels—focusing on direct and indirect costs, including OOPE and catastrophic health expenditure (CHE).

Methods and analysis

This review will follow the JBI methodology for economic evaluation evidence and adhere to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. A three-step search strategy will be used to identify relevant studies from databases, including MEDLINE (Ovid), Embase, Scopus, CINAHL (Ovid), Dentistry and Oral Sciences Source (EBSCO) and Cochrane CENTRAL, as well as grey literature sources.

We will include studies conducted in India that report on the economic burden or financial impact of oral diseases at the individual, household or population level. Eligible designs include cost-of-illness studies, cost analysis, cost-outcome analysis and health expenditure analysis using cross-sectional (including repeated cross-sectional) or cohort designs, as well as analyses based on secondary datasets. Studies using econometric, statistical or modelling methods, with or without comparators, will be included. Mixed-methods studies will be eligible if they provide extractable quantitative data.

Two reviewers will independently screen and appraise studies using JBI critical appraisal tools suited to each study design. Data extraction will focus on direct and indirect costs, including OOPE and financial impacts, such as CHE, hardship financing and poverty effects. Findings will be presented narratively and, where feasible, pooled in a meta-analysis using MetaXL V.5 software.

Ethics and dissemination

This review does not involve the collection or analysis of individual patient data. Instead, it will use data from publicly available economic research studies. All data sources will be appropriately cited. Extracted data will be systematically curated and managed using version-controlled spreadsheets and reference software. As this is a secondary analysis of published literature, ethical approval is not required. Findings will be disseminated through peer-reviewed publications and scientific presentations, as well as shared with policymakers and community health organisations via policy briefs and stakeholder outreach.

PROSPERO registration number

CRD420251030651.

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