Validity of Conducting Clinical Dysphagia Assessments for Patients with Normal to Mild Cognitive Impairment via Telerehabilitation
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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.
KeywordsDeglutition Deglutition disorders Telerehabilitation Dysphagia Swallowing disorders Aspiration Clinical swallowing examination Videoconferencing
The authors acknowledge the assistance of the Speech Pathology Department of the Royal Brisbane and Women’s Hospital in the recruitment of participants for this study, and the participants of this study for their time, patience, and cooperation. The authors also acknowledge the pilot funding provided for this work from the Royal Brisbane and Women’s Research Foundation Grants Scheme.
Conflict of interest
Elizabeth Ward, Shobha Sharma, Clare Burns, Deborah Theodoros, and Trevor Russell have no conflicts of interest or financial ties to disclose.
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