Validity of Conducting Clinical Dysphagia Assessments for Patients with Normal to Mild Cognitive Impairment via Telerehabilitation

Abstract

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.

Assessing dysphagia via telerehabilitation: Patient perceptions and satisfaction

“…The telerehabilitation session for each patient followed the same procedure detailed previously by Sharma et al (2011) and as described in detail in Ward et al (2012). In brief, this involved a clinical swallowing examination that was led by an online clinician who assessed the patient in real time during the videoconference.…”

“…Most patient satisfaction studies involve interviews or questionnaires conducted with patients after they have experienced a telehealth consultation. This methodology provides evidence regarding the patients' levels of comfort during a telehealth consultation, the user-friendliness of the equipment and technology, and the interaction between the service provider and the patient (Balas et (Ward et al, 2012). To date however, patient perceptions of such services have yet to be systematically studied.…”

Comparação dos atendimentos fonoaudiológicos virtual e presencial em profissionais do telejornalismo

“…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.…”

Face-to-Face Versus Video Assessment of Facial Paralysis: Implications for Telemedicine (Preprint)

“…For example, in Australia, there is only one major facial nerve centre -the Sydney Facial Nerve Service. In addition to limited access to relevant health professionals, individuals with FNP face common challenges to healthcare access, which include the direct and indirect cost of care, distance, transportation, mobility, and time constraints [11][12][13][14][15].…”

“…Telemedicine is healthcare delivered via telecommunications technology over a distance [11,[15][16][17][18], allowing improved access to care in various physical and mental health conditions by overcoming geographical and temporal barriers [11,[13][14][15][16][17][18][19][20][21]. Telemedicine has also been associated with increased access and compliance to pulmonary rehabilitation [22], and reduced hospitalization rates, emergency department visits, and length of hospital stay for patients with chronic obstructive pulmonary disease (COPD) [23].…”