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).

The study included a heterogeneous sample of participants with different underlying causes of dysphagia (stroke, Parkinson's, etc.) and healthy older adults, which may affect generalizability to specific patient groups. The within-subject design involved performing the tests twice on the same day, which carries a risk of learning or fatigue effects, although randomization was used to mitigate this. The number of swallows was difficult to assess reliably over telemedicine, suggesting that this specific measure is not suitable for remote administration without a trained observer in the room. One participant had a three-hour delay between assessments, unlike the rest who were tested within one hour.

No conflicts of interest or funding sources were explicitly declared in the provided text.

Do not rely on the number of swallows counted during a telemedicine assessment of solid foods as a primary indicator of dysphagia. This measure showed poor agreement with face-to-face results and led to a high rate of false positive classifications, meaning patients may be incorrectly identified as impaired.