Loh Poh-Kooi, Donaldson Mark, Flicker Leon, Maher Sean, Goldswain Peter
Department of Geriatric Medicine, Royal Perth Hospital, Perth, WA, Australia.
J Telemed Telecare. 2007;13(2):90-4. doi: 10.1258/135763307780096159.
We developed a telemedicine protocol for diagnosis of Alzheimer's Disease (AD). Assessments by video-conferencing (remote) were compared with face to face (direct) assessments. Eight physicians performed direct assessments and two physicians conducted remote assessments. There was alternate allocation of direct or remote initial assessment. The participants were 20 subjects over 65 years living in a rural area and referred by general practitioners (GPs) because of cognitive impairment. Each assessment included a Standardised Mini Mental State Examination, Geriatric Depression Scale, Katz assessment of Activities of Daily Living, Instrumental ADL assessment, and the Informant Questionnaire for Cognitive Decline in the Elderly. Laboratory results and radiological imaging were available from referring GPs. There was good agreement for diagnosing Alzheimer's disease between telemedicine and direct assessment, kappa = 0.8 (P<0.0001). However, because of the small sample size, the presence of systematic bias could not be completely excluded. We conclude that it is possible to diagnose AD at a distance using telemedicine, but this requires validation with a larger study.
我们制定了一项用于诊断阿尔茨海默病（AD）的远程医疗方案。通过视频会议（远程）进行的评估与面对面（直接）评估进行了比较。八名医生进行直接评估，两名医生进行远程评估。直接或远程初始评估采用交替分配方式。参与者为20名居住在农村地区、年龄超过65岁且因认知障碍被全科医生（GP）转诊的受试者。每次评估包括标准化简易精神状态检查、老年抑郁量表、卡茨日常生活活动能力评估、工具性日常生活活动能力评估以及老年人认知下降 informant 问卷。转诊的全科医生提供了实验室检查结果和影像学检查结果。远程医疗与直接评估在诊断阿尔茨海默病方面具有良好的一致性，kappa = 0.8（P<0.0001）。然而，由于样本量较小，无法完全排除系统偏差的存在。我们得出结论，使用远程医疗可以远程诊断AD，但这需要通过更大规模的研究进行验证。
