Reliability of prehospital real-time cellular video phone in assessing the simplified National Institutes Of Health Stroke Scale in patients with acute stroke: a novel telemedicine technology.

Abstract:

BACKGROUND AND PURPOSE:The National Institutes of Health Stroke Scale (NIHSS) is the gold standard to assess patients with acute stroke. We aimed to examine the feasibility and reliability of prehospital real-time cellular video phone (VP) in performing the NIHSS. METHODS:Forty physicians prospectively performed a simplified NIHSS (sNIHSS) on a standardized patient remotely using VP with the assistance of a bedside emergency medical technician and later performed a bedside examination. We tested the hypothesis that there is high reliability between these 2 methods. Physicians were timed and sNIHSS scores were recorded. Finally, physicians were asked to rate the VP technology. RESULTS:A total of 480 pair comparisons of the sNIHSS scores between the VP and bedside examination were generated. After adjusting for the physician's specialty, level of training, and certification status, there was a strong positive linear correlation (r=0.97, P < 0.01) between the 2 methods with high average physician reliability (0.99; 95% CI, 0.992 to 0.995). The mean sNIHSS scores using VP and bedside examination were not different (6.82 ± 1.06 versus 6.63 ± 0.98; P=0.08). The mean time to perform the sNIHSS using VP was approximately 38 seconds longer than the bedside examination (3.38 ± 0.77 versus 2.93 ± 0.83 minutes; P=0.006). CONCLUSIONS:The VP is a feasible, reliable, and timely tool with the potential for remotely assessing the sNIHSS for patients presenting with acute stroke and may expedite the initial evaluation and treatment strategies.

journal_name

Stroke

journal_title

Stroke

authors

Gonzalez MA,Hanna N,Rodrigo ME,Satler LF,Waksman R

doi

10.1161/STROKEAHA.110.600296

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

1522-7

issue

6

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.110.600296

journal_volume

42

pub_type

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