Classification of videolaryngoscopy: a systematic review
Authors' conclusion
Accuracy, performance and thresholds have been evaluated for only three classification tools, while remaining largely unknown for the other four tools.
Study context
- Population
- Studies of tools classifying videolaryngoscopic tracheal intubation in adults and children13 studies
- Comparison
- Cormack-Lehane vs Percentage of glottic opening score vs Intubation difficulty scale vs Fremantle score vs Video classification of intubation score vs videolaryngoscopic intubation and difficult airway classification (VIDIAC) vs paediatric difficult airway classification (PeDiAC)
- Outcome
- Accuracy, performance and inter-rater reliability of tools classifying videolaryngoscopic tracheal intubation
Methodological detailsQUADAS-2 quality assessment
- QUADAS-2 quality assessment
Pooled result
As reported in the abstract
- 7 distinct classification tools evaluated; many studies reported only inter-rater reliability or concordance, so accuracy, performance, generalisability and clinical utility remained uncertain
- Accuracy or performance metrics reported for 3 tools (Cormack-Lehane, VIDIAC, PeDiAC); Cormack-Lehane showed only limited performance
- Empirically-derived thresholds not reported for most tools
Further pooled results
Clinical studies in patients
- Publications reporting clinical studies in patients
- 8
Risk of bias (QUADAS-2)
- Overall risk of bias high, particularly reference standard, flow and timing, with substantial applicability concerns
Original publication
Classification of videolaryngoscopy: a systematic review. Anaesthesia. Published 26 August 2026. doi:10.
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