Development of a Remote Examination of Deglutition Based on Consensus Surveys of Clinicians (Part I): Selection of Examination Items.
Fumitaka Omori, Masako Fujiu-Kurachi, Kiyoko Iiboshi and 1 others
PMID 34435239WHAT IT FOUND
Experts reached consensus on 13 swallowing assessment items feasible for remote video exams, grouping them into oral observation, overall evaluation, and voice judgment.
The exam relies on a trained assistant to handle equipment and monitoring, as clinicians cannot palpate laryngeal movement remotely.
Key findings
01Thirteen items reached consensus for remote feasibility, organized into three factors: oral observation, overall evaluation, and perceptual voice judgment.
02Items requiring manual palpation, such as repetitive saliva swallowing, were excluded because remote examiners cannot detect laryngeal elevation distance without physical contact.
03A trained assistant is required to operate the camera, monitor oxygen saturation, and prepare materials, as the speech-language pathologist cannot perform these tasks remotely.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study establishes consensus on what is *feasible* to do remotely, not evidence that the remote exam is accurate or valid compared to face-to-face assessment. The video demonstrations used a healthy adult actor, so the results do not confirm that the items are feasible or interpretable in patients with severe dysphagia or complex medical presentations. Participants were Japanese speech-language pathologists, so the selected items and assistant roles may not align with healthcare systems or staffing models in other countries. The reliability and validity of the proposed 13-item exam have not yet been tested; this is Part I of a development process.
Declared interests
The study was funded by The Soda Toyoji Memorial Foundation. The authors declared no other conflicts of interest.
The easy way to misread this
Do not assume this remote examination is proven to be accurate or safe for diagnosing dysphagia. The study only reports that clinicians agreed these items are technically possible to perform via video, but it did not test whether the remote results match face-to-face findings or if the exam is valid for patients.