Reliability of telemedicine evaluation for EDSS functional systems in multiple sclerosis.

IF 3.2 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Journal of Telemedicine and Telecare Pub Date : 2025-06-01 Epub Date: 2023-10-31 DOI:10.1177/1357633X231207903
Cássia E Marin, Paula de O Pinto, Giordani R Dos Passos, Daissy Lm Cuervo, Mario B Wagner, Jefferson Becker, Douglas K Sato
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引用次数: 0

Abstract

Introduction: There was an increase in telemedicine during the COVID-19 pandemic to follow patients with multiple sclerosis (MS). However, there is scarce data if online evaluations can cover important information assessed during in-clinic appointments, especially the Expanded Disability Status Score (EDSS). This study aims to develop a remote evaluation tool for EDSS functional systems and compare the performance with face-to-face evaluations. Methods: This was a single-center study that included all MS patients followed up at outpatient clinics of Hospital São Lucas Pontifícia Universidade Católica do Rio Grande do Sul, between April and August 2022. Initially, patients were routinely in-clinic evaluated by one trained neurologist for EDSS. After, patients were evaluated remotely without any information about the in-clinic EDSS results. We used a standardized interview with an interactive video platform to evaluate EDSS functional systems by telemedicine. Results: Forty-nine participants completed the two steps. Intra-class coefficient was 0.97 (95% CI: 0.95-0.98), concordance for EDSS below 4.0 was 0.87 (95% CI: 0.77-0.93) and ≥4.0 was 0.97 (95% CI: 0.89-0.99). There was perfect agreement in the final EDSS in 71.4% of the online and in-clinic evaluations. In the multivariate analysis, the visual (beta = 0.453; p = 0.003) and pyramidal (beta = 0.403; p = 0.009) systems contributed significantly to the difference in the final EDSS. Conclusion: The telemedicine tool created in this study can detect changes in functional systems with reliable results compared to in-clinic EDSS assessment. Telemedicine evaluations may reduce the number of in-clinic visits and the disease burden for patients with MS.

多发性硬化症EDSS功能系统远程医疗评估的可靠性。
简介:在新冠肺炎大流行期间,追踪多发性硬化症(MS)患者的远程医疗有所增加。然而,如果在线评估能够涵盖诊所预约期间评估的重要信息,特别是扩展残疾状态评分(EDSS),那么数据就很少了。本研究旨在开发EDSS功能系统的远程评估工具,并将其与面对面的评估进行比较。方法:这是一项单中心研究,包括2022年4月至8月在南里奥格兰德州圣卢卡斯·蓬蒂菲西亚大学门诊随访的所有MS患者。最初,由一名训练有素的神经科医生对患者进行EDSS常规临床评估。之后,在没有任何关于临床EDSS结果的信息的情况下对患者进行远程评估。我们使用交互式视频平台进行标准化访谈,通过远程医疗评估EDSS功能系统。结果:49名参与者完成了两个步骤。类内系数为0.97(95%可信区间:0.95-0.98),EDSS低于4.0的一致性为0.87(95%置信区间:0.77-0.93),≥4.0的一致度为0.97。71.4%的在线和临床评估的最终EDSS完全一致。在多元分析中,视觉(β = 0.453;p = 0.003)和锥体(β = 0.403;p = 0.009)系统对最终EDSS的差异有显著贡献。结论:与临床EDSS评估相比,本研究中创建的远程医疗工具可以检测功能系统的变化,结果可靠。远程医疗评估可以减少多发性硬化症患者的临床就诊次数和疾病负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
14.10
自引率
10.60%
发文量
174
审稿时长
6-12 weeks
期刊介绍: Journal of Telemedicine and Telecare provides excellent peer reviewed coverage of developments in telemedicine and e-health and is now widely recognised as the leading journal in its field. Contributions from around the world provide a unique perspective on how different countries and health systems are using new technology in health care. Sections within the journal include technology updates, editorials, original articles, research tutorials, educational material, review articles and reports from various telemedicine organisations. A subscription to this journal will help you to stay up-to-date in this fast moving and growing area of medicine.
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