title: 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.
authors.affiliation: The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia. liz.ward@uq.edu.au
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Ward
authors.forename: Shobha
authors.initials: S
authors.lastname: Sharma
authors.forename: Clare
authors.initials: C
authors.lastname: Burns
authors.forename: Deborah
authors.initials: D
authors.lastname: Theodoros
authors.forename: Trevor
authors.initials: T
authors.lastname: Russell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010808:Physical Examination / Q000379:methods; D011793:Queensland; D019114:Remote Consultation / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D013066:Speech-Language Pathology / Q000379:methods; D049269:Videoconferencing