The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia.
Dysphagia. 2012 Dec;27(4):460-72. doi: 10.1007/s00455-011-9390-9. Epub 2012 Jan 20.
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.
为了评估通过远程康复进行临床吞咽障碍评估的有效性，对 40 名来自不同病因的吞咽障碍患者同时由面对面的言语语言病理学家（FTF-SLP）和远程康复言语语言病理学家（T-SLP）通过基于互联网的视频会议远程康复系统进行评估。吞咽障碍状况通过临床吞咽检查（CSE）方案进行评估，该方案通过专门的远程康复视频会议系统提供，并在患者端使用助手来协助评估。FTF-SLP 和 T-SLP 之间的一致性水平表明，大多数参数达到了临床可接受的一致水平。具体而言，T-SLP 和 FTF-SLP 对口腔、口运动和喉功能任务的评分之间的一致性水平达到了 75%至 100%（kappa 值为 0.36-1.0），而与食物和液体试验相关的参数的完全一致性水平为 79%至 100%（kappa 值为 0.61-1.0）。在与吸入风险和临床管理相关的参数方面，完全一致性水平在 79%至 100%之间（kappa 值为 0.49-1.0）。数据表明，通过远程康复进行的 CSE 可以提供与 FTF 环境中做出的临床决策相媲美的有效和可靠的结果。
