Burns Clare L, Ward Elizabeth C, Hill Anne J, Phillips Nick, Porter Linda
Speech Pathology & Audiology Department, Royal Brisbane & Women's Hospital, Level 2, Dr James Mayne Building, Butterfield Street, Herston, Brisbane, QLD, 4029, Australia.
School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
Dysphagia. 2016 Jun;31(3):473-83. doi: 10.1007/s00455-016-9701-2. Epub 2016 Mar 15.
A small number of studies have examined the feasibility of conducting videofluoroscopic swallow studies (VFSS) via telepractice. While the results have confirmed this potential, the systems tested to date have either reported issues that impacted the ability to analyze/interpret the VFSS recordings in real time, or they were not designed to enable real-time interpretation. Further system design is needed to establish a telepractice model that enables the VFSS assessment to be both guided and interpreted live in real time. The aim of this study was to test the feasibility and reliability of using a telepractice system to enable live VFSS assessment. Twenty adult patients underwent a VFSS assessment directed by a telepractice SLP with competency in VFSS located in another room of the hospital. The telepractice clinician led the sessions using a C20 Cisco TelePresence System. This was linked in real time via a secure telehealth network (at 4 megabits per second (Mbit/s)) to a C60 Cisco TelePresence System located in a fluoroscopy suite, connected to the digital fluoroscopy system. Levels of agreement were calculated between the telepractice clinician and a face-to-face clinician who simultaneously rated the VFSS in real time. High levels of agreement for swallowing parameters (range = 75-100 %; k = -0.34 to 1.0) and management decisions (range = 70-100 %, k = 0.64-1.0) were found. A post-session questionnaire revealed clinicians agreed that the telepractice system enabled successful remote assessment of VFSS. The findings support the potential to conduct live VFSS assessment via a telepractice model.
少数研究探讨了通过远程医疗实践进行视频荧光吞咽造影检查（VFSS）的可行性。虽然结果证实了这种可能性，但迄今为止测试的系统要么报告了影响实时分析/解读VFSS记录能力的问题，要么并非设计用于实现实时解读。需要进一步的系统设计来建立一种远程医疗实践模式，使VFSS评估能够实时得到指导和解读。本研究的目的是测试使用远程医疗实践系统进行实时VFSS评估的可行性和可靠性。20名成年患者接受了由一名具备VFSS能力的远程医疗言语语言病理学家（SLP）指导的VFSS评估，该病理学家位于医院的另一个房间。远程医疗临床医生使用C20思科远程呈现系统主持评估过程。该系统通过安全的远程医疗网络（每秒4兆比特（Mbit/s））实时连接到位于荧光透视室的C60思科远程呈现系统，该系统又与数字荧光透视系统相连。计算了远程医疗临床医生与同时实时对VFSS进行评分的面对面临床医生之间的一致性水平。结果发现，吞咽参数（范围 = 75 - 100%；卡帕值 = -0.34至1.0）和管理决策（范围 = 70 - 100%，卡帕值 = 0.64至1.0）的一致性水平较高。会后问卷调查显示，临床医生一致认为远程医疗实践系统能够成功地对VFSS进行远程评估。这些发现支持了通过远程医疗实践模式进行实时VFSS评估的可能性。
