An international pilot study of asynchronous teleconsultation for oropharyngeal dysphagia

Abstract

We investigated whether an expert's consultation provided via telemedicine could improve the quality of care for patients with dysphagia. A trained clinician completed videofluoroscopic swallowing studies (VFSS) of 17 consecutive patients in a Greek hospital. The videofluoroscopic images were then stored on a website for independent review by an expert Speech and Language Pathologist in the US. An extra Rater evaluated 20% of all data for additional reliability testing. Eight diagnostic indicators of swallowing impairment and an overall subjective severity index were recorded for each study. Clinicians were also asked to choose from ten common treatment options for patients with dysphagia. There was good inter-rater agreement for most of the diagnostic indicators examined (ranging from 78% to 90%; kappa = 0.52-0.71) between all three Raters. Agreement on overall severity ratings was exact for more than half of the patients and within one-point on the 4-point scale for all other patients except one. However, the quality of care would have been substandard for more than half of the patients if teleconsultation had not been employed. In settings where a swallowing expert is not available and real-time telemedicine is not feasible, the use of asynchronous teleconsultation can produce better quality of care for patients with dysphagia.

A telehealth approach to conducting clinical swallowing evaluations in children with cerebral palsy

“…Specifically, over the last decade, there have been several research studies examining the effectiveness and clinical utility of telehealth services in dysphagia management (Malandraki, McCullough, He, McWeeny, & Perlman, 2011;Malandraki et al, 2013;Malandraki, Roth, & Sheppard, 2014;Sharma, Ward, Burns, Theodoros, & Russell, 2011;Ward, Burns, Theodoros, & Russell, 2013;Ward, Sharma, Burns, Theodoros, & Russell, 2012a, 2012bWard et al, 2007). Most of these studies have primarily focused on adult patients and have demonstrated positive results on the feasibility and reliability of remote dysphagia evaluations (Malandraki et al, 2011;Malandraki et al, 2013;Sharma et al, 2011;Sharma, Ward, Burns, Theodoros, & Russell, 2012;Ward et al, 2013;Ward, Sharma, Burns, Theodoros, & Russell, 2012a;Ward, E. C., Sharma, S., Burns, C., Theodoros, D., & Russell, 2012b;Ward et al, 2007).…”

“…Regarding the management of dysphagia, telehealth has also been shown to significantly improve health outcomes and quality of care (Malandraki et al, 2013).…”

Comparação dos atendimentos fonoaudiológicos virtual e presencial em profissionais do telejornalismo

“…The virtual attendance is already discussed in science and also explored by Speech Language Pathology 8,9,11,12,16 . Internet, digital world, and communication networks are already tele-health services and found in worldwide [9][10][11][12]16,17 and Brazilian 8,18-20 clinician practice.…”

“…Internet, digital world, and communication networks are already tele-health services and found in worldwide [9][10][11][12]16,17 and Brazilian 8,18-20 clinician practice. Since this is a new subject in Brazil there were not found many researches about tele-health in speech language pathology.…”

Speech and language screening for children with medical complexity: A comparison of telepractice and in-person methods

“…As skills in VFSS are considered to be advanced skills (227,228), this model could be useful in upskilling local therapists. Few studies have been published in this area (229)(230)(231), although a paper in 2016 found that adult swallowing could be reliably assessed via telepractice. Future studies into paediatric VFSS via telepractice are warranted to further develop the potential of this model.…”