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脊柱外科远程医疗神经学检查的开发:一项试点试验。

Development of a Telemedicine Neurological Examination for Spine Surgery: A Pilot Trial.

作者信息

Goyal Dhruv K C, Divi Srikanth N, Schroeder Gregory D, Pfeifer Ryan, Canseco Jose A, Bowles Daniel R, Nicholson Kristen J, Patel Parthik D, Reyes Ariana A, Radcliff Kristen E, Kurd Mark F, Woods Barrett I, Kaye Ian David, Rihn Jeffrey A, Anderson David Greg, Hilibrand Alan S, Kepler Christopher K, Harrop James S, Vaccaro Alexander R

机构信息

Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital.

Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.

出版信息

Clin Spine Surg. 2020 Nov;33(9):355-369. doi: 10.1097/BSD.0000000000001066.

Abstract

STUDY DESIGN

This was a prospective cohort study.

OBJECTIVE

The objective of this study was to design and test a novel spine neurological examination adapted for telemedicine.

SUMMARY OF BACKGROUND DATA

Telemedicine is a rapidly evolving technology associated with numerous potential benefits for health care, especially in the modern era of value-based care. To date, no studies have assessed whether.

METHODS

Twenty-one healthy controls and 20 patients with cervical or lumbar spinal disease (D) were prospectively enrolled. Each patient underwent a telemedicine neurological examination as well as a traditional in-person neurological examination administered by a fellowship trained spine surgeon and a physiatrist. Both the telemedicine and in-person tests consisted of motor, sensory, and special test components. Scores were compared via univariate analysis and secondary qualitative outcomes, including responses from a satisfaction survey, were obtained upon completion of the trial.

RESULTS

Of the 20 patients in the D group, 9 patients had cervical disease and 11 patients had lumbar disease. Comparing healthy control with the D group, there were no significant differences with respect to all motor scores, most sensory scores, and all special tests. There was a high rate of satisfaction among the cohort with 92.7% of participants feeling "very satisfied" with the overall experience.

CONCLUSIONS

This study presents the development of a viable neurological spine examination adapted for telemedicine. The findings in this study suggest that patients have comparable motor, sensory, and special test scores with telemedicine as with a traditional in-person examination administered by an experienced clinician, as well as reporting a high rate of satisfaction among participants. To our knowledge, this is the first telemedicine neurological examination for spine surgery. Further studies are warranted to validate these findings.

摘要

研究设计

这是一项前瞻性队列研究。

目的

本研究的目的是设计并测试一种适用于远程医疗的新型脊柱神经学检查方法。

背景数据总结

远程医疗是一项快速发展的技术,对医疗保健具有诸多潜在益处,尤其是在现代基于价值的医疗时代。迄今为止,尚无研究评估是否……

方法

前瞻性招募了21名健康对照者和20名患有颈椎或腰椎疾病(D组)的患者。每位患者都接受了远程医疗神经学检查以及由接受过专科培训的脊柱外科医生和物理治疗师进行的传统面对面神经学检查。远程医疗和面对面检查均包括运动、感觉和特殊检查部分。通过单变量分析比较分数,并在试验完成后获得次要定性结果,包括满意度调查的反馈。

结果

D组的20名患者中,9名患有颈椎疾病,11名患有腰椎疾病。将健康对照者与D组进行比较,在所有运动分数、大多数感觉分数和所有特殊检查方面均无显著差异。该队列的满意度很高,92.7%的参与者对总体体验“非常满意”。

结论

本研究展示了一种适用于远程医疗的可行的脊柱神经学检查方法的开发。本研究结果表明,患者通过远程医疗获得的运动、感觉和特殊检查分数与经验丰富的临床医生进行的传统面对面检查相当,并且参与者的满意度很高。据我们所知,这是首次用于脊柱手术的远程医疗神经学检查。有必要进行进一步研究以验证这些发现。

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