在远程脑卒中网络的世界里，是否有一个远程儿童脑卒中评估点？在电视上执行儿科国立卫生研究院卒中量表的试点可行性研究。

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-01-10 DOI:10.1016/j.pediatrneurol.2025.01.004

Lisa Pabst MD , Melissa Chung MD , Thomas Murray DO , Melissa Hutchinson MD , Melica Nikahd MS , Guy Brock PhD , Alicia Zha MD , Warren Lo MD

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引用次数: 0

摘要

背景：远程中风评估被广泛用于远程评估疑似中风的成人，尽管尚未在儿童中进行过研究。SPOT，即通过电视进行PedNIHSS的研究，测试了在儿童中通过电视评估儿科国立卫生研究院卒中量表（PedNIHSS）的可行性。方法：招募2 ~ 17岁有或无中风的儿童，并在门诊神经病学诊所进行检查。PedNIHSS由不同的神经科医生通过电视和床边进行评估。分类内相关系数（ICCs）用于分析分类间信度。结果：招募了20名儿童；平均年龄9.2岁（范围2 ~ 17岁）。其中6人患有慢性中风。床边检查PedNIHSS总评分0 ~ 8分，平均1.65分。通过电视，20名儿童中有12名（60%）的PedNIHSS与床边检查相同，20名儿童中有19名（95%）的PedNIHSS与床边检查相同或在1分以内，具有出色的整体评分间信度(ICC = 0.92；95%置信区间：0.81,0.97)。完成床边检查和远程检查的平均时间分别为5分钟和7分钟。结论：通过电视进行PedNIHSS是可行的，准确的，并且需要与床边评估相似的时间。本研究的局限性包括样本量小和神经功能缺陷的总体负担低。未来评估通过电视进行PedNIHSS的可靠性的研究应包括在多个地点的急性护理环境中患有急性神经功能障碍的儿童。

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Is There a SPOT for Remote Pediatric Stroke Evaluation in the World of Telestroke Networks? A Pilot Feasibility Study of Performing the Pediatric National Institutes of Health Stroke Scale Over Televideo

Background

Telestroke assessments are widely used to remotely assess adults with suspected stroke, although they have not been studied in children. SPOT, the Study of Performing the PedNIHSS Over Televideo, tested the feasibility of assessing the Pediatric National Institutes of Health Stroke Scale (PedNIHSS) by televideo in children.

Methods

Children aged 2 to 17 years with and without strokes were recruited and examined in the outpatient neurology clinic. The PedNIHSS was assessed by separate neurologists via televideo and at the bedside. Intraclass correlation coefficients (ICCs) were used to analyze inter-rater reliability.

Results

Twenty children were recruited; mean age was 9.2 years (range, 2 to 17 years). Six had chronic stroke. By bedside examination, the total PedNIHSS score ranged from 0 to 8, with a mean of 1.65. By televideo, the PedNIHSS was identical to the bedside examination in 12 of 20 (60%) of the children and identical or within 1 point in 19 of 20 (95%) with excellent overall inter-rater reliability (ICC = 0.92; 95% confidence interval: 0.81, 0.97). The mean time to complete bedside and remote examinations was 5 and 7 minutes, respectively.

Conclusions

Performing the PedNIHSS over televideo is feasible, accurate, and requires similar time as a bedside evaluation. Limitations of this study include a small sample size and the overall low burden of neurological deficits. Future studies assessing the reliability of performing the PedNIHSS over televideo should include children with acute neurological deficits in the acute care setting across multiple sites.

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.