Validity of Conducting Clinical Dysphagia Assessments for Patients with Normal to Mild Cognitive Impairment via Telerehabilitation
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- Ward, E.C., Sharma, S., Burns, C. et al. Dysphagia (2012) 27: 460. doi:10.1007/s00455-011-9390-9
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To assess the validity of conducting clinical dysphagia assessments via telerehabilitation, 40 individuals with dysphagia from various etiologies were assessed simultaneously by a face-to-face speech-language pathologist (FTF-SLP) and a telerehabilitation SLP (T-SLP) via an Internet-based videoconferencing telerehabilitation system. Dysphagia status was assessed using a Clinical Swallowing Examination (CSE) protocol, delivered via a specialized telerehabilitation videoconferencing system and involving the use of an assistant at the patient’s end of the consultation to facilitate the assessment. Levels of agreement between the FTF-SLP and T-SLP revealed that the majority of parameters reached set levels of clinically acceptable levels of agreement. Specifically, agreement between the T-SLP and FTF-SLP ratings for the oral, oromotor, and laryngeal function tasks revealed levels of exact agreement ranging from 75 to 100% (kappa = 0.36–1.0), while the parameters relating to food and fluid trials ranged in exact agreement from 79 to 100% (kappa = 0.61–1.0). Across the parameters related to aspiration risk and clinical management, exact agreement ranged between 79 and 100% (kappa = 0.49–1.0). The data show that a CSE conducted via telerehabilitation can provide valid and reliable outcomes comparable to clinical decisions made in the FTF environment.