Rhys-Potter Aneirin, Cunha Maria, Sparkes Matthew, Agirre-Arrizubieta Zaloa, Goyal Sushma, Winston Joel S
GKT School of Medicine, London, UK.
Paediatric EEG Department, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK.
Epileptic Disord. 2025 Feb;27(1):44-51. doi: 10.1002/epd2.20310. Epub 2024 Dec 16.
Assessment of the value of review of home videos by a pediatric multidisciplinary team (MDT) in a pediatric neurophysiology department.
We describe and evaluate the review of home videos alongside clinical history and previous investigations from patients referred to the Evelina pediatric EEG department at a twice-monthly MDT meeting between 01/2021 and 09/2022. We retrospectively analyzed measures of video quality, quantity and duration, time taken from referral to MDT meeting, pre-MDT and post-MDT meeting proposed diagnosis and clinical outcomes. Feedback from referring doctors was obtained by a survey.
There were 36 referrals for 34 patients totalling 123 videos. There was a median delay of 10 days between video upload and final report. After the MDT meeting the number of referrals classified as uncertain fell from 15 to 2. The number of referrals classified as non-epileptic events increased from seven to 18. The number classified as infantile spasms fell from six to two. Overall, 26 of 36 referrals had a change in diagnosis and 26 of 36 referrals were triaged away from the video-EEG telemetry (VT) waiting list. Nine out of ten referring doctors reported that MDT discussion improved their understanding of the events.
HVR is a useful tool that has been successfully incorporated into our neurophysiology department's workflow. These early results suggest benefits from adopting an MDT meeting may include an early diagnosis and management approach based upon consensus. Using HVR in a pediatric population may help triage urgent cases, conserve specialized neurophysiological investigations and streamline workflows to improve the efficiency of pediatric referrals.
评估儿科多学科团队（MDT）对儿科神经生理学部门家庭视频的审查价值。
我们描述并评估了在2021年1月至2022年9月期间每月两次的MDT会议上，结合临床病史和先前检查结果对转诊至伊芙琳娜儿科脑电图部门患者的家庭视频进行的审查。我们回顾性分析了视频质量、数量和时长的指标，从转诊到MDT会议的时间，MDT会议前和会后提出的诊断以及临床结果。通过一项调查获得了转诊医生的反馈。
共收到34例患者的36份转诊，总计123份视频。视频上传至最终报告的中位延迟时间为10天。MDT会议后，分类为不确定的转诊数量从15例降至2例。分类为非癫痫性事件的转诊数量从7例增加到18例。分类为婴儿痉挛症的数量从6例降至2例。总体而言，36份转诊中有26份诊断发生了变化，36份转诊中有26份被从视频脑电图遥测（VT）等候名单中分流。十分之九的转诊医生报告称，MDT讨论增进了他们对这些事件的理解。
家庭视频审查（HVR）是一种有用的工具，已成功纳入我们神经生理学部门的工作流程。这些早期结果表明，采用MDT会议的益处可能包括基于共识的早期诊断和管理方法。在儿科人群中使用HVR可能有助于对紧急病例进行分流，节省专门的神经生理学检查，并简化工作流程以提高儿科转诊的效率。
