Telemedicine Diagnoses for Neurological Patients Effective, but Room to Improve

Teleneurological consultations overall produce accurate diagnoses in emergency situations for both stroke and nonstroke patients, but accuracy varies based on the specific diagnosis and disease case, according to new research presented at the 2022 European Stroke Organisation Conference in Lyon, France.

“Treatments via telemedicine in neurology for acute ischemic stroke is well established,” said Christina Verez Sola, Department of Neurology, Heidelberg University, Germany, and co-authors. “[But] telemedicine in neurology is increasingly used for nonstroke neurological emergencies.”

Researchers analyzed 1418 teleconsultations for a cohort of 1841 randomly selected patients within the stroke network in the Rhine-Neckar Metropolitan Region who were treated and hospitalized in 2018 and 2019. The study included in its data patient characteristics, neurological symptoms presented, cardiovascular risk factors, preliminary diagnosis made during teleneurological consultation, and final diagnosis at discharge.

Telemedicine diagnoses proved most accurate for patients receiving a diagnosis of stroke or epileptic seizure. Of 867 patients initially diagnosed with stroke, 73.82% received a matching diagnosis on discharge. For those initially diagnosed with epileptic seizure, 87.17% received a matching diagnosis on discharge. The study also showed that diagnostic accuracy for diseases relating to internal medicine were quite accurate, with 79.87% of cases matching diagnoses from the telemedicine consultation and at discharge.

The lowest accuracy rate for diagnosis via teleneurological consultations was reflected in patients displaying other neurological diseases. Just 65.71% of diagnoses aligned between online meeting and hospital discharge.

“In view of the rising number of teleneurological consultation of patients with nonstroke related symptoms, further research and development of new algorithms to improve diagnostic accuracy are necessary, concluded Verez Sola et al.

References

Verez Sola C, Nagel S, Gutschalk A, et al. Diagnostic accuracy for neurological patients via telemedicine. Poster presented at: European Stroke Organisation Conference; May 4-6, 2022; Lyon, France.