Feasibility and accuracy of teleconcussion for acute evaluation of suspected concussion

Bert B. Vargas, Morgan Shepard, Joseph G. Hentz, Cherisse Kutyreff, L. George Hershey, Amaal Starling

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To assess the feasibility and accuracy of telemedical concussion evaluations (teleconcussion) for real-time athletic sideline assessment of concussion, as such assessment may address the gap in access some populations of athletes have to providers with expertise in concussion evaluation. Methods: A cohort of 11 consecutive male collegiate football players with suspected concussion was assessed using Standardized Assessment of Concussion (SAC), King-Devick test (K-D), and modified Balance Error Scoring System (mBESS). A remote neurologist assessed each athlete using a telemedicine robot with real-time, 2-way audiovisual capabilities, while a sideline provider performed a simultaneous face-to-face assessment. After the assessment, a remove-from-play (RFP) determination was made. The remote and the face-to-face providers were blinded to each other's examination findings and RFP decision until the end of the assessment. Results: The teleconcussion and face-to-face SAC were in agreement 100% of the time (6/6; 95% confidence interval [CI] 54%-100%). The mean (SD) difference between remote and sideline K-D times was 0.7 (1.4) seconds. Remote and sideline K-D times were within a 3-second difference 100% of the time (11/11; 95% CI 72%-100%). Remote and sideline mBESS scores were within 3 points 100% of the time (6/6; 95% CI 54%-100%). RFP decisions were in agreement 100% of the time (11/11; 95% CI 72%-100%). Conclusions: The aim of this study was to investigate the feasibility of teleconcussion for sideline concussion assessments. These data suggest a high level of agreement between remote and face-to-face providers with regard to examination findings and RFP determinations.

Original languageEnglish (US)
Pages (from-to)1580-1583
Number of pages4
JournalNeurology
Volume88
Issue number16
DOIs
StatePublished - Apr 18 2017
Externally publishedYes

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Confidence Intervals
Athletes
Football
Telemedicine
Sports
Population
Neurologists

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Feasibility and accuracy of teleconcussion for acute evaluation of suspected concussion. / Vargas, Bert B.; Shepard, Morgan; Hentz, Joseph G.; Kutyreff, Cherisse; Hershey, L. George; Starling, Amaal.

In: Neurology, Vol. 88, No. 16, 18.04.2017, p. 1580-1583.

Research output: Contribution to journalArticle

Vargas, BB, Shepard, M, Hentz, JG, Kutyreff, C, Hershey, LG & Starling, A 2017, 'Feasibility and accuracy of teleconcussion for acute evaluation of suspected concussion', Neurology, vol. 88, no. 16, pp. 1580-1583. https://doi.org/10.1212/WNL.0000000000003841
Vargas, Bert B. ; Shepard, Morgan ; Hentz, Joseph G. ; Kutyreff, Cherisse ; Hershey, L. George ; Starling, Amaal. / Feasibility and accuracy of teleconcussion for acute evaluation of suspected concussion. In: Neurology. 2017 ; Vol. 88, No. 16. pp. 1580-1583.
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AU - Shepard, Morgan

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AU - Hershey, L. George

AU - Starling, Amaal

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N2 - Objective: To assess the feasibility and accuracy of telemedical concussion evaluations (teleconcussion) for real-time athletic sideline assessment of concussion, as such assessment may address the gap in access some populations of athletes have to providers with expertise in concussion evaluation. Methods: A cohort of 11 consecutive male collegiate football players with suspected concussion was assessed using Standardized Assessment of Concussion (SAC), King-Devick test (K-D), and modified Balance Error Scoring System (mBESS). A remote neurologist assessed each athlete using a telemedicine robot with real-time, 2-way audiovisual capabilities, while a sideline provider performed a simultaneous face-to-face assessment. After the assessment, a remove-from-play (RFP) determination was made. The remote and the face-to-face providers were blinded to each other's examination findings and RFP decision until the end of the assessment. Results: The teleconcussion and face-to-face SAC were in agreement 100% of the time (6/6; 95% confidence interval [CI] 54%-100%). The mean (SD) difference between remote and sideline K-D times was 0.7 (1.4) seconds. Remote and sideline K-D times were within a 3-second difference 100% of the time (11/11; 95% CI 72%-100%). Remote and sideline mBESS scores were within 3 points 100% of the time (6/6; 95% CI 54%-100%). RFP decisions were in agreement 100% of the time (11/11; 95% CI 72%-100%). Conclusions: The aim of this study was to investigate the feasibility of teleconcussion for sideline concussion assessments. These data suggest a high level of agreement between remote and face-to-face providers with regard to examination findings and RFP determinations.

AB - Objective: To assess the feasibility and accuracy of telemedical concussion evaluations (teleconcussion) for real-time athletic sideline assessment of concussion, as such assessment may address the gap in access some populations of athletes have to providers with expertise in concussion evaluation. Methods: A cohort of 11 consecutive male collegiate football players with suspected concussion was assessed using Standardized Assessment of Concussion (SAC), King-Devick test (K-D), and modified Balance Error Scoring System (mBESS). A remote neurologist assessed each athlete using a telemedicine robot with real-time, 2-way audiovisual capabilities, while a sideline provider performed a simultaneous face-to-face assessment. After the assessment, a remove-from-play (RFP) determination was made. The remote and the face-to-face providers were blinded to each other's examination findings and RFP decision until the end of the assessment. Results: The teleconcussion and face-to-face SAC were in agreement 100% of the time (6/6; 95% confidence interval [CI] 54%-100%). The mean (SD) difference between remote and sideline K-D times was 0.7 (1.4) seconds. Remote and sideline K-D times were within a 3-second difference 100% of the time (11/11; 95% CI 72%-100%). Remote and sideline mBESS scores were within 3 points 100% of the time (6/6; 95% CI 54%-100%). RFP decisions were in agreement 100% of the time (11/11; 95% CI 72%-100%). Conclusions: The aim of this study was to investigate the feasibility of teleconcussion for sideline concussion assessments. These data suggest a high level of agreement between remote and face-to-face providers with regard to examination findings and RFP determinations.

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