Research Reports - Feasibility and accuracy of teleconcussion for acute evaluation of suspected concussion

Neurology. 2017 Apr 18;88(16):1580-1583. doi: 10.1212/WNL.0000000000003841. Epub
2017 Mar 24.

Vargas BB(1), Shepard M(2), Hentz JG(2), Kutyreff C(2), Hershey LG(2), Starling

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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