Swallow and Voice Outcomes
Swallowing and voice outcomes were influenced by curtailed access during COVID-19 to instrumental assessments typically used in intensive care settings such as fibreoptic endoscopic evaluation of swallowing (FEES). Presence and severity of PED was measured using the Functional Oral Intake Scale (FOIS) (19). The FOIS is a validated 7-point ordinal rating scale with high inter-rater reliability (19). A second proxy dysphagia measure was food and fluid consistencies required for dysphagia management, using the International Dysphagia Diet Standardisation Initiative (IDDSI) (20). Voice quality was evaluated using the overall Grade (G) score from the GRBAS scale (21). The scale has established high rater reliability (21) and is widely used in clinical research (12).