A Pilot Study of Virtual Visits in Huntington Disease
A Pilot Study of Virtual Visits in Huntington Disease
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DOI：
10.3233/jhd-140102
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发表时间：
2014-01-01
影响因子：
3.1
通讯作者：
Biglan, Kevin M.
中科院分区：
文献类型：
--
作者：
Bull, Michael T.;Darwin, Kristin;Biglan, Kevin M.
背景资料：通过基于网络的视频会议的虚拟访问可以增加亨廷顿病（HD）患者获得专业护理的机会，并促进研究参与。目的：确定直接进入HD患者家中进行虚拟访问的可行性，评估进行远程与面对面运动评估的可靠性，并确定远程进行运动评估的重测信度。方法：轻度至中度HD患者接受了基线亲自诊所评估，并完成了HD护理调查。参与者被随机分配到两名医生中的一名，在四个月内接受三次虚拟访问，其中包括通过基于网络的视频会议进行的修改后的统一亨廷顿疾病评定量表运动检查（不包括刚性和平衡评估）。计算组内系数（ICC），以确定远程评估和面对面评估之间的一致性水平。参与者还完成了一项调查，他们的兴趣在telemedicine.Results：13个人进行了基线评估，11（85%）参与者完成了至少一个虚拟访问，27（82%）的33个虚拟访问完成。与现场运动评分相比，远程运动评分表现出良好的可靠性（ICC = 0.78; n = 11）。远程运动评分的重测信度良好（ICC = 0.90; n = 11）。与会者表示温和的未来的兴趣，使用虚拟访问参与研究和接受care.Conclusion：在这项试点研究中，虚拟访问到家里进行运动评估HD是可行和可靠的。更大规模的研究需要确认并将这些发现推广到更广泛的参与者人群。
Background: Virtual visits through web-based video conferencing can increase access to specialty care for individuals with Huntington disease (HD) and facilitate research participation.Objective: To determine the feasibility of conducting virtual visits directly into the homes of individuals with HD, to assess the reliability of conducting remote versus in-person motor assessments, and to determine the test-retest reliability of conducting motor assessments remotely.Methods: Individuals with mild to moderate HD underwent baseline in-person clinic assessments and completed a HD care survey. Participants were randomized to receive three virtual visits from one of two physicians over four months that included a modified Unified Huntington's Disease Rating Scale motor examination (excluding rigidity and balance assessments) via webbased video conferencing. Intraclass coefficients (ICC) were calculated to determine the level of agreement between remote and in-person assessments. Participants also completed a survey on their interest in telemedicine.Results: Thirteen individuals underwent baseline assessments, eleven (85%) participants completed at least one virtual visit, and 27 (82%) of 33 total virtual visits were completed. Remote motor scores demonstrated good reliability (ICC = 0.78; n = 11) compared to in-person motor scores. Test-retest reliability of motor scores conducted remotelywas excellent (ICC = 0.90; n = 11). Participants expressed moderate future interest in using virtual visits to participate in research and to receive care.Conclusion: In this pilot study, virtual visits into the home were feasible and reliable for conducting motor assessments in HD. Larger scale studies need to confirm and generalize these findings to a broader population of participants.