Kaiser Permanente Orange County and UCLA Stroke Center, Irvine, California.
UCLA Stroke Center, Los Angeles, California.
J Stroke Cerebrovasc Dis. 2019 Oct;28(10):104258. doi: 10.1016/j.jstrokecerebrovasdis.2019.06.016. Epub 2019 Jul 9.
Telestroke is an efficient, cost-effective way to standardize care and improve access to immediate neurologic expertise for rural hospitals and other underserved areas. Hands-free wearable technology potentially allows for faster evaluations that fit easily within prehospital workflows and could improve prehospital triage of stroke patients to appropriate receiving stroke centers. The goal of this study is to assess the feasibility and inter-rater reliability of wearable eyeglass video technology in assessing stroke-related neurologic deficits in patients with suspected acute stroke.
Consecutive patients with suspected stroke were evaluated concurrently by an on-site neurologist using wearable eyeglass video technology and a remotely located neurologist viewing the patient through an online platform. Inter-rater reliability in assigning National Institutes of Health Stroke Scale (NIHSS) scores was evaluated using inter-rater correlation coefficient (ICC) and weighted kappa scores.
Among 17 enrolled patients, mean age was 58 (SD ± 20) and 29% were female. There was a high degree of correlation in total NIHSS score (ICC .99 and weighted kappa .88) and across all NIHSS subitems (ICC .81-1 and weighted kappa .68-1) between the examiner evaluating remotely via wearable eyeglass video technology with access to the patient and the in-person examiner. The maximum difference between the 2 NIHSS scores was 3.
The use of wearable eyeglass video technology in telestroke is feasible and reliable. Use of this technology in the prehospital setting has the potential to improve early assessment of patients with acute stroke symptoms and to facilitate transfer to appropriate stroke centers in the regional systems of care.
远程卒中是一种高效、经济有效的方式，可以为农村医院和其他服务不足地区的患者提供标准化的护理，并使他们能够立即获得神经科专业知识。免提可穿戴技术可以实现更快速的评估，并且非常适合于院前工作流程，从而可以改善对卒中患者的院前分诊，使其能够被转至合适的卒中接收中心。本研究旨在评估可穿戴眼镜视频技术在评估疑似急性卒中患者的卒中相关神经功能缺损方面的可行性和组内一致性。
连续的疑似卒中患者同时由现场神经科医生使用可穿戴眼镜视频技术和通过在线平台观看患者的远程神经科医生进行评估。使用组内相关系数（ICC）和加权 Kappa 评分评估分配 NIHSS 评分的组内一致性。
在 17 名入组患者中，平均年龄为 58 岁（SD ± 20 岁），29%为女性。通过可穿戴眼镜视频技术远程评估的检查者与现场检查者之间的总 NIHSS 评分（ICC.99 和加权 Kappa.88）和所有 NIHSS 亚项（ICC.81-1 和加权 Kappa.68-1）均具有高度相关性。
在远程卒中中使用可穿戴眼镜视频技术是可行且可靠的。在院前环境中使用这项技术有可能改善对急性卒中症状患者的早期评估，并促进在区域性医疗服务系统中将患者转至合适的卒中中心。
