Division of Speech Pathology, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
J Telemed Telecare. 2012 Jun;18(4):198-203. doi: 10.1258/jtt.2012.111116. Epub 2012 May 17.
We examined the validity and reliability of an Internet-based telehealth system for screening speech intelligibility and oro-motor structure, and function in children with speech disorders. Twenty children aged 4-9 years were assessed by a clinician in the conventional, face-to-face (FTF) manner; simultaneously, they were assessed by a second clinician via the videoconferencing system using a 128-kbit/s Internet connection. Speech intelligibility in conversation was rated and an informal assessment of oro-motor structure and function was conducted. There was a high level of agreement between the online and FTF speech intelligibility ratings, with 70% exact agreement and 100% close agreement (within ± point on a 5-point scale). The weighted kappa statistic revealed very good agreement between raters (kappa = 0.86). Data for online and FTF ratings of oro-motor function revealed overall exact agreement of 73%, close agreement of 96%, moderate or good strength of agreement for six variables (kappa = 0.48-0.74), and poor to fair agreement for six variables (kappa = 0.12-0.36). Intra- and inter-rater reliability measures (ICCs) were similar between the online and FTF assessments. Low levels of agreement for some oro-motor variables highlighted the subjectivity of this assessment. However, the overall results support the validity and reliability of Internet-based screening of speech intelligibility and oro-motor function in children with speech disorders.
我们研究了一种基于互联网的远程医疗系统，用于筛查言语清晰度和口腔运动结构及功能，以评估患有言语障碍的儿童。20 名年龄在 4-9 岁的儿童由临床医生以传统的面对面（FTF）方式进行评估；同时，他们由另一位临床医生通过视频会议系统使用 128 kbit/s 的互联网连接进行评估。会话中的言语清晰度进行了评估，并对口腔运动结构和功能进行了非正式评估。在线和 FTF 言语清晰度评估之间具有高度的一致性，70%的精确一致性和 100%的接近一致性（在 5 分制的±1 分范围内）。加权kappa 统计显示评估者之间具有非常好的一致性（kappa = 0.86）。口腔运动功能的在线和 FTF 评估数据显示，整体精确一致性为 73%，接近一致性为 96%，6 个变量的一致性为中等或良好（kappa = 0.48-0.74），6 个变量的一致性为差到中等（kappa = 0.12-0.36）。在线和 FTF 评估之间的内部和外部评估者可靠性测量（ICC）相似。一些口腔运动变量的低水平一致性突出了该评估的主观性。然而，总体结果支持基于互联网的言语清晰度和口腔运动功能筛查在患有言语障碍的儿童中的有效性和可靠性。
