Comparing telemedicine with bedside evaluations of coma patients

Evaluating patients with a limited level of consciousness (LOC) has steadily become a practice conducted via telemedicine. A team of researchers set out to measure exactly how effective telemedicine can be when completing remote assessments of patients with LOC.

The study, published in Mary Ann Liebert Inc., included 100 participants split between telemedicine and bedside evaluations. Using both the Glasgow Coma Scale (GCS) and Full Scale Of UnResponsiveness (FOUR), researchers compared bedside and telemedicine assessments of patients with limited LOC. GCS and FOUR scores were then compared to Pearson correlation coefficient (PCC) scores for bedside and telemedicine reviews.

Results showed the average exam time spanned 5.16 minutes. Mean GCS bedside scores were measured at 7.5 compared to 7.23 using telemedicine. Mean FOUR bedside scores were measured at 9.63 compared to 9.21 using telemedicine. The PCC score for GCS was .966 and for FOUR score at .912. Overall, 95 percent of telemedicine users rated GCS as effective, satisfactory and easy to use, compared to 86 percent for FOUR.

“Differences between total bedside and remote GCS and FOUR scores were small,” concluded Amelia K. Adcock, MD, and colleagues. “Furthermore, PCCs between remote and bedside assessments were excellent: 0.97 (GCS) and 0.91 (FOUR). These results suggest that LOC can be reliably assessed using existing robotic telemedicine technology. Telemedicine could be adopted to help evaluate critically ill patients in neurologically underserved areas.”