Document Detail


Teleneurology in patients with multiple sclerosis: EDSS ratings derived remotely and from hands-on examination.
MedLine Citation:
PMID:  18534953     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We compared the telemedicine assessment of 20 patients with multiple sclerosis (MS) with the findings of a hands-on examiner. The remote specialist was a neurologist with expertise in MS; the hands-on examination was performed by an experienced mid-level practitioner. We also compared the findings of a second specialist viewing the examination in the room with the patient. The videoconference link operated at a bandwidth of 384 kbit/s. All three examiners independently completed a standardized rating scale for neurological functions. Cronbach's alpha for the three raters' total expanded disability status scale (EDSS) score was 0.99 with individual correlations ranging from 0.96-0.97. Agreement between raters for individual neurological domain scores was more variable. The most consistent assessments were for optic, bowel and bladder, and cerebral functions. The least consistent were for cerebellar and brain stem functions. Agreement between the remote and local examiners was similar to that reported for different neurological examiners directly assessing the same patient using the EDSS rating system.
Authors:
Robert L Kane; Christopher T Bever; Mary Ehrmantraut; Alan Forte; William J Culpepper; Mitchell T Wallin
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of telemedicine and telecare     Volume:  14     ISSN:  1357-633X     ISO Abbreviation:  J Telemed Telecare     Publication Date:  2008  
Date Detail:
Created Date:  2008-06-06     Completed Date:  2008-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9506702     Medline TA:  J Telemed Telecare     Country:  England    
Other Details:
Languages:  eng     Pagination:  190-4     Citation Subset:  IM    
Affiliation:
VA Medical Center, MS Center of Excellence, Baltimore, MD 21201, USA. robert.kane@va.gov
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MeSH Terms
Descriptor/Qualifier:
Diagnosis, Computer-Assisted / methods*
Disability Evaluation
Female
Gait
Humans
Male
Middle Aged
Multiple Sclerosis / diagnosis*
Neurologic Examination / instrumentation*,  methods
Physical Examination / methods
Pilot Projects
Reproducibility of Results
Severity of Illness Index
Telemedicine / instrumentation*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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