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Updated: Oct 7, 2025
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Published on: December 9, 2015
Reliability of televisits for patients with mild relapsing-remitting multiple sclerosis in the COVID-19 era
Simona Toscano1, Francesco Patti2, Clara Grazia Chisari1
1Department "G.F. Ingrassia", Section of Neurosciences, Neurology Clinic, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
Background:
Evidence of the cost-effectiveness of telemedicine (TM) for the management of Multiple Sclerosis (MS) has been provided recently. However, some doubts persist about the accuracy of neurological examinations performed remotely.
Objectives:
This study investigated the reliability of neurological evaluations performed through TM in mild MS patients as compared with standard in-person visits.
Methods:
In total, 76 patients with relapsing-remitting MS and Expanded Disability Status Scale (EDSS) ≤ 3.5 were consecutively recruited. Of them, 40 patients (52.6%) accepted to undergo both in-person and TM evaluations with independent examiners within 48 h. We alternatively asked patients to assure or not the presence of a caregiver during TM visits. A satisfaction questionnaire was administered to all participants.
Results:
The inter-rater agreement attributed by two independent neurologists during TM visit was high (κ > 0.80) for EDSS and Functional Systems (FS) scores. Moderate agreement between TM and in-person evaluations emerged for pyramidal (κ = 0.57; p < 0.001), brainstem (κ = 0.57; p < 0.001), bowel and bladder (κ = 0.54; p < 0.001) and sensory (κ = 0.51; p < 0.001) FS scores, higher in patients providing the support of a caregiver. A good reliability was reported for EDSS scores computed during remote and in-person visits (ICC = 0.83; 95% CI 0.70-0.91; p < 0.001).
Conclusions:
Despite the complexity of neurological examination, TM could be useful in monitoring MS patients with low disability.
