Мақаланы E-mail арқылы жіберу Telehealth for patients with vestibular disorders
- Авторлар: Tishkina A.V.1, Guseva A.L.1,2, Kryukov A.I.1,3, Demkina A.E.1,3
-
Мекемелер:
- The Russian National Research Medical University named after N.I. Pirogov
- Moscow City Clinical Hospital No. 1 named after N.I. Pirogov
- The Sverzhevskiy Otorhinolaryngology Healthcare Research Institute
- Шығарылым: Том 5, № 1S (2024)
- Беттер: 106-108
- Бөлім: Articles by YOUNG SCIENTISTS
- ##submission.dateSubmitted##: 16.02.2024
- ##submission.dateAccepted##: 22.03.2024
- ##submission.datePublished##: 03.07.2024
- URL: https://jdigitaldiagnostics.com/DD/article/view/627082
- DOI: https://doi.org/10.17816/DD627082
- ID: 627082
Дәйексөз келтіру
Толық мәтін
Аннотация
BACKGROUND: The diagnosis of vestibular disorders, which are manifested by the complaint of dizziness and unsteadiness, is a challenging task for physicians of all specialties in outpatient practice [1]. The otoneurological examination of a patient with vertigo by a qualified specialist is only possible in some clinics, which limits the availability of this type of specialized care and the timely diagnosis of patients with vestibular disorders [2, 3]. Telemedicine has been the subject of investigation in the field of vestibular rehabilitation, with encouraging results [4]. Over the past decade, however, the relevance of telemedicine has been on the rise in the context of the development of information and communication technologies. Telemedicine has the potential to significantly enhance the accessibility of quality medical care to the population, overcoming geographical barriers and the shortage of narrow-profile specialists.
AIM: The study aimed to identify the features of telemedicine counseling for patients with vestibular disorders.
MATERIALS AND METHODS: The DSC.Clinic telemedicine platform was used to consult with 20 patients aged 27 to 85 years (mean age 54.1±5.4 years; 13 women and 7 men, without division into groups). The consultations included the collection of complaints and anamnesis, as well as familiarization with the results of examinations prescribed by other specialists. The duration of the consultations was 20 minutes. Furthermore, the diagnostic concept of vestibular disorder was established, and the patients were provided with recommendations for additional examinations, as well as for nonpharmacological and symptomatic treatment. Over the subsequent 1–2 weeks, a comprehensive clinical otoneurologic examination, clinical diagnosis, and treatment prescription were conducted in person. The comparability of telemedicine and in-person consultation, as well as the features of remote counseling for patients with vestibular disorders, were evaluated.
RESULTS: In all cases, patients were referred to an otoneurologist by other specialists with the diagnosis of vestibulopathy of unclear etiology. Of the 20 patients, 16 (80%) were referred by a neurologist, and 4 (20%) by an otorhinolaryngologist. As part of remote counseling, five patients (25%) were recommended to undergo an audiologic study, and four patients (20%) were advised to maintain a headache diary. When collecting anamnesis, 11 patients (55%) had episodic vestibular syndrome, 7 patients (35%) had chronic vestibular syndrome, and 2 patients (10%) had acute vestibular syndrome. In 6 cases (30%), the diagnostic concept included a single vestibular disorder. In 6 cases (30%), an association of vestibular disorders was suggested. In 8 cases (40%), a differential diagnostic series of possible vestibulopathies was proposed. Following in-person consultation, the diagnostic concept was fully confirmed in 10 patients (50% of cases), with 6 patients (30% of cases) having their diagnosis from the previously proposed differential series confirmed. Four patients (20%) required further follow-up.
CONCLUSIONS: Remote consultation of a patient with vestibular disorder allows for the prescription of an examination plan in advance for the purpose of clinical diagnosis. This paper presents initial data on the analysis of the effectiveness of telemedicine counseling in otoneurology. It is planned to examine and analyze more patients to develop the most optimal algorithm for the use of telemedicine in various types of vestibular pathology. The data obtained following the in-person otoneurologic examination indicated that in 80% of cases, the diagnosis was consistent with the predetermined differential diagnostic series. Furthermore, in half of all cases, the diagnostic concept was fully consistent with the clinical diagnosis. In foreign literature, the issues of telemedicine application for remote monitoring and vestibular rehabilitation have been actively discussed for several years [5], in contrast to the Russian studies, which allows to consider the described study as promising and the issue as requiring further study.
Негізгі сөздер
Толық мәтін
BACKGROUND: The diagnosis of vestibular disorders, which are manifested by the complaint of dizziness and unsteadiness, is a challenging task for physicians of all specialties in outpatient practice [1]. The otoneurological examination of a patient with vertigo by a qualified specialist is only possible in some clinics, which limits the availability of this type of specialized care and the timely diagnosis of patients with vestibular disorders [2, 3]. Telemedicine has been the subject of investigation in the field of vestibular rehabilitation, with encouraging results [4]. Over the past decade, however, the relevance of telemedicine has been on the rise in the context of the development of information and communication technologies. Telemedicine has the potential to significantly enhance the accessibility of quality medical care to the population, overcoming geographical barriers and the shortage of narrow-profile specialists.
AIM: The study aimed to identify the features of telemedicine counseling for patients with vestibular disorders.
MATERIALS AND METHODS: The DSC.Clinic telemedicine platform was used to consult with 20 patients aged 27 to 85 years (mean age 54.1±5.4 years; 13 women and 7 men, without division into groups). The consultations included the collection of complaints and anamnesis, as well as familiarization with the results of examinations prescribed by other specialists. The duration of the consultations was 20 minutes. Furthermore, the diagnostic concept of vestibular disorder was established, and the patients were provided with recommendations for additional examinations, as well as for nonpharmacological and symptomatic treatment. Over the subsequent 1–2 weeks, a comprehensive clinical otoneurologic examination, clinical diagnosis, and treatment prescription were conducted in person. The comparability of telemedicine and in-person consultation, as well as the features of remote counseling for patients with vestibular disorders, were evaluated.
RESULTS: In all cases, patients were referred to an otoneurologist by other specialists with the diagnosis of vestibulopathy of unclear etiology. Of the 20 patients, 16 (80%) were referred by a neurologist, and 4 (20%) by an otorhinolaryngologist. As part of remote counseling, five patients (25%) were recommended to undergo an audiologic study, and four patients (20%) were advised to maintain a headache diary. When collecting anamnesis, 11 patients (55%) had episodic vestibular syndrome, 7 patients (35%) had chronic vestibular syndrome, and 2 patients (10%) had acute vestibular syndrome. In 6 cases (30%), the diagnostic concept included a single vestibular disorder. In 6 cases (30%), an association of vestibular disorders was suggested. In 8 cases (40%), a differential diagnostic series of possible vestibulopathies was proposed. Following in-person consultation, the diagnostic concept was fully confirmed in 10 patients (50% of cases), with 6 patients (30% of cases) having their diagnosis from the previously proposed differential series confirmed. Four patients (20%) required further follow-up.
CONCLUSIONS: Remote consultation of a patient with vestibular disorder allows for the prescription of an examination plan in advance for the purpose of clinical diagnosis. This paper presents initial data on the analysis of the effectiveness of telemedicine counseling in otoneurology. It is planned to examine and analyze more patients to develop the most optimal algorithm for the use of telemedicine in various types of vestibular pathology. The data obtained following the in-person otoneurologic examination indicated that in 80% of cases, the diagnosis was consistent with the predetermined differential diagnostic series. Furthermore, in half of all cases, the diagnostic concept was fully consistent with the clinical diagnosis. In foreign literature, the issues of telemedicine application for remote monitoring and vestibular rehabilitation have been actively discussed for several years [5], in contrast to the Russian studies, which allows to consider the described study as promising and the issue as requiring further study.
Авторлар туралы
Anna Tishkina
The Russian National Research Medical University named after N.I. Pirogov
Email: avtishkina@yandex.ru
ORCID iD: 0009-0007-2804-3685
SPIN-код: 4116-9292
Ресей, Moscow
Alexandra Guseva
The Russian National Research Medical University named after N.I. Pirogov; Moscow City Clinical Hospital No. 1 named after N.I. Pirogov
Email: avtishkina@yandex.ru
ORCID iD: 0000-0002-7988-4229
SPIN-код: 4417-2650
Ресей, Moscow; Moscow
Andrei Kryukov
The Russian National Research Medical University named after N.I. Pirogov; The Sverzhevskiy Otorhinolaryngology Healthcare Research Institute
Email: avtishkina@yandex.ru
ORCID iD: 0000-0001-8483-2530
SPIN-код: 9393-8753
Ресей, Moscow; Moscow
Alexandra Demkina
The Russian National Research Medical University named after N.I. Pirogov; The Sverzhevskiy Otorhinolaryngology Healthcare Research Institute
Хат алмасуға жауапты Автор.
Email: avtishkina@yandex.ru
ORCID iD: 0000-0002-8004-9725
SPIN-код: 4657-5501
Ресей, Moscow; Moscow
Әдебиет тізімі
- Walther LE. Current diagnostic procedures for diagnosing vertigo and dizziness. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2017;16. doi: 10.3205/cto000141
- Makarov SA, Guseva AL. Diagnosis and treatment of dizziness and vertigo in clinical practice. Medical alphabet. 2023;(21):23–29. EDN: LUKLDC doi: 10.33667/2078-5631-2023-21-23-29
- Barreto RG, Yacovino DA, Teixeira LJ, Freitas MM. Teleconsultation and teletreatment protocol to diagnose and manage patients with benign paroxysmal positional vertigo (BPPV) during the COVID-19 Pandemic. Int Arch Otorhinolaryngol. 2021;25(01):e141–e149. doi: 10.1055/s-0040-1722252
- Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular Rehabilitation Telehealth During the SAEA-CoV-2 (COVID-19) Pandemic. Front. Neurol. 2022;12. doi: 10.3389/fneur.2021.781482
- Miller LE, Rathi VK, Kozin ED, et al. Telemedicine Services Provided to Medicare Beneficiaries by Otolaryngologists Between 2010 and 2018. JAMA Otolaryngol Head Neck Surg. 2020;146(9):816–821. doi: 10.1001/jamaoto.2020.1911
Қосымша файлдар
