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A within-subject comparison of face-to-face and telemedicine screening using the timed water swallow test (TWST) and the test of mastication and swallowing of solids (TOMASS)
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.ORCID iD: 0000-0003-3373-0934
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
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2023 (English)In: Dysphagia (New York. Print), ISSN 0179-051X, E-ISSN 1432-0460, Vol. 38, p. 483-490Article in journal (Refereed) Published
Abstract [en]

The Timed Water Swallow Test (TWST) and the Test of Mastication of Solids (TOMASS) are dysphagia screening procedures that have been shown to be reliably assessed from video. The reliability of the procedures performed over telemedicine has not previously been assessed. TWST and TOMASS outcomes in two situations (both face-to-face and over telemedicine) were compared for 48 participants (aged 60-90; 27 with clinical conditions and 21 older persons). Both testing situation and test performed order were randomized, and all assessment procedures were performed within 3 h of each other. The results indicated a high level of agreement between face-to-face and telemedicine screening outcomes for TWST and TOMASS, respectively. The assessments indicated an 83% and 76% agreement in classifications of individual participants as within or outside normal limits for the TWST and TOMASS for the two test situations. The TWST showed a balanced distribution in differing classification in telemedicine (0.16-0.19 error rates). The TOMASS procedure classified more participants as outside normal limits over telemedicine compared to face-to-face administration. Agreement in the observed number of swallows was substantially lower than other outcome measures, which is attributed to increased difficulty in observing this property over video. Most participants (60%) reported that they would prefer telemedicine over face-to-face assessments, and 90% viewed the procedure as more accessible than expected. All participants were satisfied with the telemedicine procedures. The results suggest that clinical assessment of dysphagia over telemedicine using the TWST and TOMASS are viable alternatives to face-to-face administration of the procedures.

Place, publisher, year, edition, pages
Springer, 2023. Vol. 38, p. 483-490
Keywords [en]
Comparison of administration situations, Dysphagia screening, Telemedicine
National Category
Other Medical Sciences not elsewhere specified
Research subject
Oto-Rhino-Laryngology
Identifiers
URN: urn:nbn:se:umu:diva-197988DOI: 10.1007/s00455-022-10490-wISI: 000822477700004PubMedID: 35809097Scopus ID: 2-s2.0-85133601458OAI: oai:DiVA.org:umu-197988DiVA, id: diva2:1682412
Available from: 2022-07-10 Created: 2022-07-10 Last updated: 2023-06-19Bibliographically approved

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Karlsson, FredrikBrage, LouiseHägglund, Patricia

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