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Use of a telestroke service for evaluation of non-stroke neurological cases

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Abstract

Telemedicine is a growing field in many medical specialties. Within clinical neurosciences one of its largest applications is in acute stroke care. However, little is known about its value and effect in general neurology, despite stroke. In a retrospective survey of 1500 teleconsultations over a time period of 12 months from October 2008 to September 2009, from a large telestroke network in Germany, we evaluated 352 cases with a non-stroke diagnosis. Duration and methods of teleconsultation as well as neurological consultations at bedside and discharge diagnosis were analyzed and compared to stroke cases. Discharge diagnosis was not identical to teleconsultation diagnosis in 48.9 % of all non-stroke cases compared to 12.5 % of all stroke cases. Duration of teleconsultation was 26.5 min in non-stroke cases compared to 14.3 min for stroke cases. In non-stroke cases other parts of the neurological examination were added to the pure administration of a stroke scale. There were no significant differences between non-stroke cases with correct and incorrect consultation diagnoses concerning in-hospital mortality (4.6 vs. 5.0 %) and length of hospital stay (8.3 vs. 7.6 days). We conclude that diagnostic accuracy and protocol routine is not as exact in non-stroke cases compared to acute stroke cases. Other neurologic conditions may need different algorithms for a telemedicine service. Thus experience from a telestroke service cannot be transferred to other neurologic conditions on a routine basis.

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Acknowledgments

We are very grateful to Dr. Heike Schmolck for proof-reading the manuscript. The STENO-Network is funded by the Health Insurances in Bavaria and by the Bavarian State Ministry of Health.

Conflicts of interest

None of the authors has any conflict of interest or any financial relationship to companies or products named in this article.

Ethical standard

This was a retrospective study from routine data out of the STENO network and does not contain clinical studies data. However, it was conducted according to all common ethical standards governed by the University of Erlangen and according to the rules of the STENO contract.

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Authors and Affiliations

  1. Department of Neurology, Klinikum Neumarkt, Nürnberger Str. 12, 92318, Neumarkt, Germany

    René Handschu

  2. STENO Coordinating Office, Department of Neurology, Universitätsklinikum Erlangen, Erlangen, Germany

    René Handschu, Angela Wacker, Mateusz Scibor, Stefan Schwab, David Stark & Lars Marquardt

  3. Department of Internal Medicine, Klinikum Kulmbach, Kulmbach, Germany

    Camelia Sancu

  4. Department of Neurology, Klinikum Nürnberg, Nürnberg, Germany

    Frank Erbguth

  5. Department of Neurology, Klinikum Bayreuth, Bayreuth, Germany

    Patrick Oschmann

Authors
  1. René Handschu
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  2. Angela Wacker
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  3. Mateusz Scibor
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  4. Camelia Sancu
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  5. Stefan Schwab
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  6. Frank Erbguth
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  7. Patrick Oschmann
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  8. David Stark
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  9. Lars Marquardt
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Corresponding author

Correspondence to René Handschu.

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Handschu, R., Wacker, A., Scibor, M. et al. Use of a telestroke service for evaluation of non-stroke neurological cases. J Neurol 262, 1266–1270 (2015). https://doi.org/10.1007/s00415-015-7702-y

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  • DOI: https://doi.org/10.1007/s00415-015-7702-y

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