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This can lead to pneumonia, choking, malnutrition, and dehydration. Currently, the diagnostic gold standard uses radiologic imaging, the videofluoroscopic swallow study (VFSS); however, it is expensive and necessitates specialized facilities and trained personnel. Although several devices attempt to address the limitations, none offer the clinical\u2010grade quality and accuracy of the VFSS. Here, this study reports a wireless multimodal wearable system with machine learning for automatic, accurate clinical assessment of swallowing behavior and diagnosis of silent aspirations from dysphagia patients. The device includes a kirigami\u2010structured electrode that suppresses changes in skin contact impedance caused by movements and a microphone with a gel layer that effectively blocks external noise for measuring high\u2010quality electromyograms and swallowing sounds. The deep learning algorithm offers the classification of swallowing patterns while diagnosing silent aspirations, with an accuracy of 89.47%. The demonstration with post\u2010stroke patients captures the system's significance in measuring multiple physiological signals in real\u2010time for detecting swallowing disorders, validated by comparing them with the VFSS. The multimodal electronics can ensure a promising future for dysphagia healthcare and rehabilitation therapy, providing an accurate, non\u2010invasive alternative for monitoring swallowing and aspiration events.<\/jats:p>","DOI":"10.1002\/advs.202404211","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T15:28:23Z","timestamp":1720538903000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Automatic Clinical Assessment of Swallowing Behavior and Diagnosis of Silent Aspiration Using Wireless Multimodal Wearable Electronics"],"prefix":"10.1002","volume":"11","author":[{"given":"Beomjune","family":"Shin","sequence":"first","affiliation":[{"name":"George W. 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Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University School of Medicine  Atlanta GA 30332 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So\u2010Young","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Chungnam National University School of Medicine  Daejeon 35015 Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Shelly","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Emory University  Atlanta GA 30322 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Sundholm","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Emory University  Atlanta GA 30322 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Tkaczuk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Emory University  Atlanta GA 30322 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min\u2010Kyung","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Pathology Chungnam National University School of Medicine  Daejeon 35015 Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyojung J.","family":"Choo","sequence":"additional","affiliation":[{"name":"Department of Cell Biology School of Medicine Emory University  Atlanta GA 30322 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5526-3882","authenticated-orcid":false,"given":"Woon\u2010Hong","family":"Yeo","sequence":"additional","affiliation":[{"name":"George W. 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