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[远程医疗支持系统在基层医疗中诊断痴呆症的可行性]

[Feasibility of a telemedicine support system for diagnosing dementia in primary care].

作者信息

Vilalta-Franch Joan, Garre-Olmo Josep, López-Pousa Secundino, Llinàs-Reglà Jordi, Calvó-Perxas Laia, Cubí-Montfort Rafael

机构信息

Unitat de Valoració de la Memòria i les Demències, UVAMID, España.

出版信息

Rev Neurol. 2012 Sep 1;55(5):263-9.

Abstract

INTRODUCTION

The Computerised Support System for the Diagnosis of Dementia in Primary Care (SISDDAP, in Spanish) is an asynchronous telemedicine programme that establishes protocols for the screening and diagnosis of dementia, thereby enabling primary care (PC) and specialised care (SC) professionals to reach shared diagnoses of dementia.

AIMS

To determine the feasibility and degree of implementation of an asynchronous telemedicine programme and to evaluate the rate of agreement between the cognitive and functional measures taken by professionals from two different levels of healthcare.

PATIENTS AND METHODS

The study examines the use of the SISDDAP programme by professionals from four basic areas of healthcare (BAH) in which the programme was introduced on a voluntary basis. The absolute and relative frequency of use of the SISDDAP programme and the number of variables registered were calculated, together with the intra-class correlation coefficient among the scores obtained by PC and SC professionals on the different psychometric instruments, including the SISDDAP diagnostic module (Mini-Mental State Examination, Blessed Dementia Rating Scale and Patient Health Questionnaire 9).

RESULTS

The four BAH that incorporated the SISDDAP referred 215 (45.3%) applications via the telemedicine programme, and 82.2% of these applications had a maximum of two data items missing. The intra-class correlation coefficient was above 0.70 among all the instruments evaluated.

CONCLUSIONS

The SISDDAP is an asynchronous telemedicine programme that is well accepted among PC professionals. After suitable training, the level of agreement among the psychometric instruments is acceptable.

摘要

引言

初级保健中痴呆症诊断的计算机支持系统(西班牙语为SISDDAP)是一个异步远程医疗项目,该项目建立了痴呆症筛查和诊断的协议,从而使初级保健(PC)和专科护理(SC)专业人员能够就痴呆症达成共同诊断。

目的

确定异步远程医疗项目的可行性和实施程度,并评估来自两个不同医疗保健级别的专业人员所采取的认知和功能测量之间的一致率。

患者与方法

该研究考察了来自四个医疗保健基本领域(BAH)的专业人员对SISDDAP项目的使用情况,这些领域是自愿引入该项目的。计算了SISDDAP项目的绝对和相对使用频率以及记录的变量数量,同时还计算了PC和SC专业人员在不同心理测量工具(包括SISDDAP诊断模块,即简易精神状态检查表、Blessed痴呆评定量表和患者健康问卷9)上获得的分数之间的组内相关系数。

结果

采用SISDDAP的四个BAH通过远程医疗项目提交了2×15(45.3%)份申请,其中82.2%的申请最多有两项数据缺失。在所有评估工具中,组内相关系数均高于0.70。

结论

SISDDAP是一个异步远程医疗项目,在PC专业人员中得到了广泛认可。经过适当培训后,心理测量工具之间的一致程度是可以接受的。

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