Videofluoroscopic Swallowing Study (VFSS)

DDS signals and VFSS will be recorded simultaneously (for the same bolus) using barium
contrast agent stimuli prepared in three consistencies: thin, mildly-thick and
moderately-thick. Subjects will undergo VFSS with simultaneous DDS using up to 5 boluses of
thin barium stimulus ("THIN-Ba"), and up to 4 boluses of barium thickened to mildly
("MILD-Ba") thick and up to 4 boluses of moderately ("MODERATE-Ba") thick barium
consistencies using Resource Thicken Up Clear Nestlé Health Science (TUC). 4, 3 and 3 boluses
for THIN-Ba, MILD-Ba and MOD-Ba will be analyzed using the classifier algorithms for
sensitivity/specificity results. According to the exploratory trial, VFSS data for safety or
efficiency can be missing for up to 14% boluses due to quality of VFSS recording. To
compensate for potential losses of boluses due to missing gold standard (VFSS) data, 5, 4 and
4 boluses will be collected for the three consistencies respectively . The DDS signals will
be sent to a dedicated application software installed at the CRO, which interprets the
acceleration data and displays the examination result. The VFSS recording will be sent to CRO
and provided for blinded assessment by the independent central VFSS laboratory.The study
procedure of simultaneous VFSS and DDS measurement will be completed in one day and the
subject will be followed within 2 business days after the study procedure to monitor for
adverse events.

Inclusion Criteria:

- Adult subjects (over 18 years of age)

- Hospitalized subjects or outpatients identified as at risk of oropharyngeal dysphagia
(using local practice)

- Patients belong to one of the following groups:

- Stroke patients

- Traumatic brain injury

- Parkinson Disease (PD) stage III or higher by Hoehn and Yahr scale

- Multiple Sclerosis (MS) above age 60

- Alzheimer Disease (AD) or other Dementia

- Other medically complex hospitalized subjects not covered by the exclusion criteria
and identified as at risk of dysphagia

- Subject is able to comply with VFSS protocol to diagnose dysphagia

- Subject is able to give voluntary, written informed consent to participate in the
clinical investigation and from whom consent has been obtained / or a consultee has
consented on he subjects behalf in line with nationally agreed guidelines concerning
adults unable to consent for themselves.

Exclusion Criteria:

- Presence of nasogastric / nasojejunal feeding tube at the time of VFSS test

- Currently has a tracheostomy, or has had a tracheostomy in the past year

- Had posterior cervical spine surgery and/or carotid endarterectomy in the last 6
months

- Had significant surgery to the mouth and/or neck, for example resection for oral or
pharyngeal cancer, radical neck dissection, anterior cervical spine surgery, orofacial
reconstruction, pharyngoplasty, or thyroidectomy. Routine tonsillectomy and/or
adenoidectomy are not excluded

- Experienced non-surgical trauma to the neck (e.g., knife wound) resulting in
musculoskeletal or nerve injury in the neck.

- Received radiation or chemotherapy to the oropharynx or neck for cancer.

- Allergy to oral radiographic contrast media (specifically barium)

- Distorted oropharyngeal anatomy (e.g. pharyngeal pouch)

- Cognitive impairment that prevents them from being able to comply with study
instructions and procedures

- Known to be pregnant at the time of enrollment

- Currently has significant facial hair at the location of sensor adherence and are
unwilling/unable to be shaved

- Any patients the local investigator finds that participation would not be in patients'
best interest