Original ArticleRemote Assessment of Stroke Using the iPhone 4
Section snippets
Subjects and Methods
The study protocol was approved by Emory University’s Institutional Review Board and Grady Memorial Hospital’s Research Oversight Committee. Each patient or a family member who could serve as a legal representative gave consent for participation in this study. The study included 20 patients (9 males and 11 females) admitted to the neurology inpatient service at Grady Memorial Hospital for acute stroke. Patients who were clinically unstable were not included in the study.
Twenty patients with
Results
The average NIHSS scores were similar for the bedside and remote raters (6.05 and 6.30, respectively, with a range of 0-22 for both groups). Distributions of the values assigned to each NIHSS component are presented in Table 1. The mean remote evaluation time was 8.45 minutes.
Ten components of the NIHSS showed quasi-perfect agreement between the bedside and remote rates: level of consciousness, month and age, visual fields, right motor arm, left motor arm, right motor leg, left motor leg,
Discussion
In the event of an acute stroke where there is no vascular neurologist on site, using telemedicine to provide such expertise is a class I, level A recommendation.8 Telemedicine has been available for use in the assessment and management of acute stroke patients for more than a decade. Unfortunately, the startup costs associated with currently available systems is substantial, potentially upwards of several thousands of dollars.20, 21, 23 These costs are prohibitive for small rural hospitals and
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