Use of Wearable Technology in Remote Evaluation of Acute Stroke Patients: Feasibility and Reliability of a Google Glass-Based Device
Use of Wearable Technology in Remote Evaluation of Acute Stroke Patients: Feasibility and Reliability of a Google Glass-Based Device
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DOI：
10.1016/j.jstrokecerebrovasdis.2019.06.016
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发表时间：
2019-10-01
影响因子：
2.5
通讯作者：
Sharma, Latisha K.
中科院分区：
文献类型：
--
作者：
Noorian, Ali Reza;Hosseini, Mersedeh Bahr;Sharma, Latisha K.
背景：对于农村医院和其他服务不足的地区，远程中风是一种有效的、具有成本效益的方法，可以使护理标准化，并改善获得即时神经专业知识的机会。免提可穿戴技术可能允许更快的评估，很容易适应院前工作流程，并可以改善院前分流中风患者到适当的接收中风中心。本研究的目的是评估可穿戴眼镜视频技术在评估疑似急性卒中患者卒中相关神经功能缺损方面的可行性和可靠性。方法：由现场神经科医生使用可穿戴式眼镜视频技术和远程神经科医生通过在线平台观察患者同时对连续的疑似中风患者进行评估。评定美国国立卫生研究院卒中量表（NIHSS）评分时，采用评分间相关系数（ICC）和加权kappa评分评估评分间信度。结果：17例入组患者的平均年龄为58岁（SD +/- 20），其中29%为女性。与NIHSS总分（ICC）有高度相关。99和加权kappa。88)和所有NIHSS分项(ICC。81-1和加权kappa。68-1)审查员通过可穿戴式眼镜视频技术远程评估患者与现场审查员之间的关系。两组NIHSS评分最大差异为3分。结论：可穿戴式眼镜视频技术在中风患者中的应用是可行、可靠的。在院前环境中使用这项技术有可能改善对急性卒中症状患者的早期评估，并促进转移到区域护理系统中适当的卒中中心。
Background: Telestroke is an efficient, cost-effective way to standardize care and improve access to immediate neurologic expertise for rural hospitals and other underserved areas. Hands-free wearable technology potentially allows for faster evaluations that fit easily within prehospital workflows and could improve prehospital triage of stroke patients to appropriate receiving stroke centers. The goal of this study is to assess the feasibility and inter-rater reliability of wearable eyeglass video technology in assessing stroke-related neurologic deficits in patients with suspected acute stroke. Methods: Consecutive patients with suspected stroke were evaluated concurrently by an on-site neurologist using wearable eyeglass video technology and a remotely located neurologist viewing the patient through an online platform. Inter-rater reliability in assigning National Institutes of Health Stroke Scale (NIHSS) scores was evaluated using inter-rater correlation coefficient (ICC) and weighted kappa scores. Results: Among 17 enrolled patients, mean age was 58 (SD +/- 20) and 29% were female. There was a high degree of correlation in total NIHSS score (ICC .99 and weighted kappa .88) and across all NIHSS subitems (ICC .81-1 and weighted kappa .68-1) between the examiner evaluating remotely via wearable eyeglass video technology with access to the patient and the in-person examiner. The maximum difference between the 2 NIHSS scores was 3. Conclusions: The use of wearable eyeglass video technology in telestroke is feasible and reliable. Use of this technology in the prehospital setting has the potential to improve early assessment of patients with acute stroke symptoms and to facilitate transfer to appropriate stroke centers in the regional systems of care.