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相关概念视频

Data Collection III01:05

Data Collection III

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The physical assessment examines the patient for objective data that defines the patient's condition, and aids in formulating the nursing care plan. The purpose of physical assessment is a health status appraisal, which includes identifying health problems, and establishing a database for nursing intervention.
The principles to begin the physical assessment include conducting a comprehensive or problem-related history in a quiet, well-lit room, emphasizing privacy and comfort for the...
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虚拟与实体神经检查相比的神经检查研究

Lauren Hophing1, Tiffany Tse1, Nicole Naimer1

  • 1Division of Neurology (LH, MM, AI, HK, CDK, SBM), Department of Medicine; Neurology Quality and Innovation Lab (LH, TT, NN, HK, CDK, SBM); Division of Neurology (MM, AI, HK, SBM), Department of Medicine, Sunnybrook Health Sciences Centre; Sunnybrook Research Institute (MM, SSM, HK, SBM), University of Toronto, Ontario, Canada; Division of Neurology (CDK), Department of Medicine; Li Ka Shing Knowledge Institute (CDK), St. Michael's Hospital; Department of Psychiatry (SBM), Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; and Azrieli Brian Medicine Fellowship Program (SBM), Toronto, Ontario, Canada.

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概括

虚拟神经学检查 (VNE) 显示了与面对面检查相当的一致性,特别是对于步行. 虽然对于初始咨询很有用,但由于敏感性较低,正常的VNE需要进行面对面的随访.

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科学领域:

  • 神经学 神经学
  • 远程医疗远程医疗
  • 临床评估 临床评估

背景情况:

  • 随着COVID-19的流行,神经病学领域的虚拟护理的采用加速了.
  • 虚拟神经检查 (VNE) 与实体神经检查 (IPNE) 相比,虚拟神经检查的诊断有效性仍未得到充分研究.

研究的目的:

  • 与IPNE相比,评估VNE在实现准确的定位和诊断方面的实用性.
  • 为了比较VNE与IPNE在门诊神经病学环境中的准确性,定位和诊断能力.

主要方法:

  • 从一般神经病学和神经肌肉诊所对81名患者的回顾性图表审查.
  • 使用科恩卡帕系数和描述统计数据对VNE和IPNE结果进行比较.
  • 在虚拟和实体评估之间进行本地化和诊断的协议分析.

主要成果:

  • 在VNE和IPNE之间达成公平的总体协议 (64%);对于步行异常,达成实质性的协议.
  • 与IPNE相比,VNE表现出86%的特异性和56%的敏感性.
  • 在一些病例中发现了一致的局部化 (44%) 和诊断 (57%),在其他病例中发现了修改.

结论:

  • 在特定场景中,VNE显示为初始咨询的潜在有效性,特别是对于步行异常.
  • 由于VNE的敏感性较低,因此需要对正常的虚拟考试进行面对面的后续检查,特别是有关历史的考试.
  • 在检测微妙的异常方面,IPNE仍然优越,支持在VNE正常时面对面访问的低门.