Feldheim Jonas, Schmidt Teresa, Oster Christoph, Feldheim Julia, Stuschke Martin, Stummer Walter, Grauer Oliver, Scheffler Björn, Hagemann Carsten, Sure Ulrich, Kleinschnitz Christoph, Lazaridis Lazaros, Kebir Sied, Glas Martin
Division of Clinical Neuro-Oncology, Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, University Duisburg-Essen, 45147 Essen, Germany.
Section Experimental Neurosurgery, Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany.
Cancers (Basel). 2023 Aug 11;15(16):4054. doi: 10.3390/cancers15164054.
In order to minimize the risk of infections during the COVID-19 pandemic, remote video consultations (VC) experienced an upswing in most medical fields. However, telemedicine in neuro-oncology comprises unique challenges and opportunities. So far, evidence-based insights to evaluate and potentially customize current concepts are scarce. To fill this gap, we analyzed >3700 neuro-oncological consultations, of which >300 were conducted as VC per patients' preference, in order to detect how both patient collectives distinguished from one another. Additionally, we examined patients' reasons, suitable/less suitable encounters, VC's benefits and disadvantages and future opportunities with an anonymized survey. Patients that participated in VC had a worse clinical condition, higher grade of malignancy, were more often diagnosed with glioblastoma and had a longer travel distance (all < 0.01). VC were considered a fully adequate alternative to face-to-face consultations for almost all encounters that patients chose to participate in (>70%) except initial consultations. Most participants preferred to alternate between both modalities rather than participate in one alone but preferred VC over telephone consultation. VC made patients feel safer, and participants expressed interest in implementing other telemedicine modalities (e.g., apps) into neuro-oncology. VC are a promising addition to patient care in neuro-oncology. However, patients and encounters should be selected individually.
为了在新冠疫情期间将感染风险降至最低，远程视频会诊（VC）在大多数医学领域都呈上升趋势。然而，神经肿瘤学中的远程医疗既包含独特的挑战，也蕴含机遇。到目前为止，评估并可能定制当前概念的循证见解尚少。为填补这一空白，我们分析了3700多例神经肿瘤会诊，其中根据患者偏好有300多例采用视频会诊，以探究这两类患者群体之间的差异。此外，我们通过一项匿名调查研究了患者选择视频会诊的原因、适合/不太适合视频会诊的情况、视频会诊的优缺点以及未来的机遇。参与视频会诊的患者临床状况更差、恶性程度更高，更常被诊断为胶质母细胞瘤，且出行距离更远（所有P值均<0.01）。除了初次会诊外，对于患者选择参与的几乎所有会诊（>70%），视频会诊被认为是面对面会诊的完全合适替代方式。大多数参与者更喜欢在两种方式之间交替，而不是只采用一种方式，但比起电话会诊，他们更喜欢视频会诊。视频会诊让患者感觉更安全，参与者表示有兴趣在神经肿瘤学中采用其他远程医疗方式（如应用程序）。视频会诊是神经肿瘤学患者护理中有前景的补充方式。然而，患者和会诊应进行个体化选择。
