Chinese People's Liberation Army General Hospital, Beijing, China.
Chang-De First People's Hospital, Changde, China.
JMIR Mhealth Uhealth. 2019 Sep 12;7(9):e11229. doi: 10.2196/11229.
The diagnosis of paroxysmal events in infants is often challenging. Reasons include the child's inability to express discomfort and the inability to record video electroencephalography at home. The prevalence of mobile phones, which can record videos, may be beneficial to these patients. In China, this advantage may be even more significant given the vast population and the uneven distribution of medical resources.
The aim of this study is to investigate the value of mobile phone videos in increasing the diagnostic accuracy and cost savings of paroxysmal events in infants.
Clinical data, including descriptions and home videos of episodes, from 12 patients with paroxysmal events were collected. The investigation was conducted in six centers during pediatric academic conferences. All 452 practitioners present were asked to make their diagnoses by just the descriptions of the events, and then remake their diagnoses after watching the corresponding home videos of the episodes. The doctor's information, including educational background, profession, working years, and working hospital level, was also recorded. The cost savings from accurate diagnoses were measured on the basis of using online consultation, which can also be done easily by mobile phone. All data were recorded in the form of questionnaires designed for this study.
We collected 452 questionnaires, 301 of which met the criteria (66.6%) and were analyzed. The mean correct diagnoses with and without videos was 8.4 (SD 1.7) of 12 and 7.5 (SD 1.7) of 12, respectively. For epileptic seizures, mobile phone videos increased the mean accurate diagnoses by 3.9%; for nonepileptic events, it was 11.5% and both were statistically different (P=.006 for epileptic events; P<.001 for nonepileptic events). Pediatric neurologists with longer working years had higher diagnostic accuracy; whereas, their working hospital level and educational background made no difference. For patients with paroxysmal events, at least US $673.90 per capita and US $128 million nationwide could be saved annually, which is 12.02% of the total cost for correct diagnosis.
Home videos made on mobile phones are a cost-effective tool for the diagnosis of paroxysmal events in infants. They can facilitate the diagnosis of paroxysmal events in infants and thereby save costs. The best choice for infants with paroxysmal events on their initial visit is to record their events first and then show the video to a neurologist with longer working years through online consultation.
婴儿阵发性事件的诊断通常具有挑战性。原因包括儿童无法表达不适，以及无法在家中记录视频脑电图。在中国，由于人口众多且医疗资源分布不均，手机普及（可以录制视频）可能对这些患者有益。
本研究旨在探讨手机视频在提高婴儿阵发性事件诊断准确性和节省成本方面的价值。
收集了 12 例阵发性事件患儿的临床资料，包括事件描述和家庭视频。在儿科学术会议期间，在六个中心进行了调查。所有 452 名在场的从业者仅根据事件描述进行诊断，然后观看相应的家庭视频片段后再次进行诊断。还记录了医生的信息，包括教育背景、专业、工作年限和工作医院级别。基于在线咨询节省的成本进行了准确诊断的测量，在线咨询也可以通过手机轻松进行。所有数据均以本研究设计的问卷形式记录。
共收集了 452 份问卷，其中 301 份符合标准（66.6%）并进行了分析。有和没有视频时的平均正确诊断分别为 12 个中的 8.4（SD 1.7）和 7.5（SD 1.7）。对于癫痫发作，手机视频使平均准确诊断提高了 3.9%；对于非癫痫性事件，提高了 11.5%，两者均有统计学差异（癫痫事件 P=.006；非癫痫事件 P<.001）。工作年限较长的儿科神经科医生具有更高的诊断准确性；然而，他们工作的医院级别和教育背景没有差异。对于阵发性事件患者，每年至少可节省人均 673.90 美元，全国范围内可节省 1.28 亿美元，占正确诊断总成本的 12.02%。
手机上的家庭视频是一种经济有效的婴儿阵发性事件诊断工具。它们可以帮助诊断婴儿阵发性事件，从而节省成本。对于首次就诊的阵发性事件婴儿，最好的选择是先记录他们的事件，然后通过在线咨询将视频展示给工作年限较长的神经科医生。
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