Real-Time Remote Telefluoroscopic Assessment of Patients with Dysphagia
College: Applied Health Sciences
Award year: 2001-2002
Dysphagia (disordered swallowing) is a compilation of symptoms associated with a variety of medical diagnoses. It is a serious health problem that affects persons of all ages from the neonate to those of advanced age. The consequences of dysphagia can include lung fibrosis, aspiration pneumonia, malnutrition, and death. Within the US, dysphagia has been reported to occur in approximately 14% of patients who are in acute care hospitals, 33% of those in rehabilitation centers and 45% of those who reside in nursing homes. Traditionally, patients are evaluated in the hospital fluoroscopy suite by a speech pathologist who has expertise in the evaluation and treatment of swallowing disorders. Many small communities or areas with sparse populations do not have such specialists available to them. Furthermore, at this time, persons with dysphagia who live in many countries throughout the world are very poorly served. Telemedicine is one method by which people in these areas can be served. The intent of this work is to further the development of an Internet system that permits real-time, remote, interactive, evaluation of oral/pharyngeal swallowing function. The PI was a Faculty Fellow in 1999-2000. As a result of that support, the proposed system has progressed to the level that we can now control and perform evaluations at remote sites. However, development is not complete and there are a variety of issues that can only be resolved if funding is approved for one more year. The major objectives are (1) to complete the design of a program that will permit the evaluation of patients who reside in remote or underserved areas and who are therefore unlikely to receive adequate medical attention for their dysphagia and (2) to become a Dysphagia Science Portal for those who diagnose and who research in the area of deglutition disorders. Once developed, this system can provide equity of access for underserved groups who do not have access to medical specialists. Underserved populations in Illinois include the elderly, the poor, and those who live in rural areas; however, this system will have the capability to be used in any hospital that has access to the internet anywhere on the globe. Along with the major objectives stated above, supportive objectives to be completed during the coming year include 1) development of and conversion to MPEG2 streaming 2) subjective assessment and objective image analysis of the differences in video quality as a result of changing from the inexpensive MPEG1 to the more costly MPEG2 3) comparison of transmitted image quality as a function of network topology 4) refinement of the user interface on the control and analysis computer that is to be used by swallowing specialists who have varying levels of computer competence, and further development of the system so that patient confidentiality can be assured. Additionally the PI would like to have the expertise of NCSA to assist in the establishment of strategic industrial partnerships with the private sector.