Automated Assessment of Test of Masticating and Swallowing Solids Using a Neck‐Worn Electronic Stethoscope: A Pilot Study

Background The Test of Masticating and Swallowing Solids (TOMASS) is a validated screening tool for assessing masticatory and swallowing functions. However, the conventional TOMASS relies on operator‐dependent methods, which limit its objectivity and efficiency. The neck‐worn electronic stethoscope (NWES), a contact sensor positioned on the back of the neck, has recently been developed to automatically detect and monitor swallowing actions through deep learning‐based analysis of collected sound data. Objective This study piloted a semi‐automated assessment approach using a NWES to objectively measure TOMASS parameters and examine the influence of age and gender. Methods A total of 123 healthy adults (mean age: 58.7 ± 18.5 years) consumed two crackers while audio data recorded using a NWES and visual data were collected by smartphone. Measurements included discrete bite count, swallow count, oral processing and swallowing time (OPST), and first OPST (1st‐OPST). Statistical analyses were conducted to assess gender‐ and age‐related changes and differences. Results The NWES enabled objective and precise TOMASS measurements. Age‐related prolongation of OPST and 1st‐OPST was observed, particularly in men ( p < 0.001). Women exhibited fewer age‐related changes in OPST, although swallow count tended to decrease with age ( p < 0.001). Regarding gender differences, younger women demonstrated higher bite (2.3 [interquartile range (IQR): 1.0–3.0] vs. 1 [IQR: 1.0–2.0], p = 0.042) and swallow counts (2.5 [IQR: 2.0–2.5] vs. 2 [IQR: 1.0–2.0], p = 0.026) compared with men. Conclusion The NWES appeared suitable as an objective, efficient tool for automated TOMASS evaluation. Age‐related changes in masticatory and swallowing performance differed according to gender, highlighting the need for tailored assessments. Future research on NWES‐based TOMASS measurements should include diverse populations and extension to dysphagia and masticatory dysfunction.