title: Teledynamic evaluation of oropharyngeal swallowing.
abstract: OBJECTIVE
  The objective of the present investigation was to test the feasibility and clinical utility of a real-time Internet-based protocol for remote, telefluoroscopic evaluation of oropharyngeal swallowing.
  
  
  METHODS
  In this prospective cohort study, the authors evaluated 32 patients with a primary diagnosis of stroke or head/neck cancer. All patients participated in 2 separate fluoroscopic swallowing evaluations--one traditional on site and one telefluoroscopic off site--through the use of a telemedicine system. Agreement between sites was tested for 3 categories of variables: (a) overall severity of swallowing difficulty, (b) presence and extent of laryngeal penetration and aspiration as rated by the 8-point Penetration-Aspiration scale, and (c) treatment recommendations.
  
  
  RESULTS
  Results showed overall good agreement in subjective severity ratings (κ = 0.636) and in Penetration-Aspiration scale ratings (mean absolute difference = 1.1 points) between the onsite and offsite clinicians. Agreement in treatment recommendations was moderate to high, ranging from 69.3% to 100%.
  
  
  CONCLUSIONS
  The present study supports the feasibility and clinical utility of a telemedicine system for evaluating oropharyngeal swallowing. Given the difficulty and expertise needed to complete such evaluations, this study offers promising clinical avenues for patients in rural, remote, and underserved communities and countries where expert swallowing specialists are not available.
authors: University of Illinois at Urbana–Champaign, USA.
authors: Georgia A
authors: GA
authors: Malandraki
authors: Gary
authors: G
authors: McCullough
authors: Xuming
authors: X
authors: He
authors: Elizabeth
authors: E
authors: McWeeny
authors: Adrienne L
authors: AL
authors: Perlman
mesh_terms: D000368:Aged; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy / Q000379:methods* / Q000706:statistics & numerical data; D006258:Head and Neck Neoplasms / Q000150:complications; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009960:Oropharynx / Q000000981:diagnostic imaging* / Q000502:physiology; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications; D017216:Telemedicine / Q000379:methods* / Q000706:statistics & numerical data; D014741:Video Recording / Q000379:methods / Q000706:statistics & numerical data