Related Experiment Video
Updated: Aug 5, 2026

Point-of-Care Ultrasound: A Review of Ultrasound Parameters for Predicting Difficult Airways
Published on: April 7, 2023
Sitting Versus Supine Modified Mallampati Test for Predicting Difficult Airway: A Systematic Review and Meta-analysis
Bui Thien Nghiep Vo1, Yen-Phi Huynh1,2, Phuong Minh Tang1,3
1From the International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
The modified Mallampati test for predicting difficult airways shows similar accuracy whether patients are sitting or supine. This suggests the supine position is a viable alternative when patients cannot sit upright during airway evaluation.
Area of Science:
- Anesthesiology and Critical Care Medicine
- Airway Management
Background:
- The modified Mallampati test predicts difficult airways but is usually done sitting.
- Its accuracy in the supine position is unclear, especially for patients unable to sit.
Purpose of the Study:
- To compare the diagnostic performance of the modified Mallampati test in supine versus sitting positions.
- To evaluate if patient position affects the test's accuracy in predicting difficult laryngoscopy.
Main Methods:
- Systematic review and meta-analysis of 20 observational studies (8261 patients).
- Searched PubMed, Embase, Cochrane, Web of Science up to January 2026.
- Analyzed pooled sensitivity and specificity for difficult laryngoscopy (Cormack-Lehane grade ≥III) in both positions.
Main Results:
- Pooled sensitivity for sitting: 0.661; supine: 0.750.
- Pooled specificity for sitting: 0.783; supine: 0.705.
- Patient position was not a statistically significant factor influencing test accuracy.
Conclusions:
- The modified Mallampati test's accuracy for predicting difficult airways is not significantly affected by patient position.
- Supine modified Mallampati assessment is a suitable alternative when upright assessment is not feasible.
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