Exploring the Utility of Virtual Clinics for Neurosurgical Patient Consults: Cohort Study to Assess Feasibility
Notice bibliographique
Résumé
Background: The popularity of virtual clinics has increased in many settings, especially during and following the COVID-19 pandemic. However, their applicability in neurosurgical care remains understudied. Objective: The primary goal of this study was to assess the feasibility of conducting a larger, more definitive study at our hospital site in the future. We assessed participant enrollment rate, ability to complete a neurosurgical consult virtually, need for a third party to be present, and participant satisfaction rates. Preliminary evidence on the utility of virtual examination substitutes, compared to currently used in-person assessments, was also explored in our sample of neurosurgical patients. Methods: In this feasibility study, a cohort of neurosurgery patients, consisting of both new referrals and follow-up visits, was evaluated. Each patient participated in a virtual neurological assessment via Zoom and subsequently in an in-person assessment. Both visits were completed by the same physician. We compared clinical findings and treatment decisions (surgical vs conservative management) between the 2 settings and recorded patient satisfaction with the virtual consultation. Results: A total of 95 patients were deemed eligible for the study, and of the 52 patients contacted, 35 provided verbal consent and were enrolled. Both the virtual and in-person assessments were completed by 30 participants (86%) with an average length of 3.25 days between visits, which was within the required 2-week period outlined in the study protocol. No barriers were noted from participants (n=6; 20%) who required a third party to be present and this individual was present at both visits. Participant satisfaction rate with the virtual consults exceeded 90%. Clinical decisions were consistent between both visits in 28 cases, and in the 2 visits where decisions differed, it was noted to be a result of inconclusive findings during the virtual consultation. Comparison of individual examination components between the virtual and in-person consultations revealed exam findings to be consistent 77% of the time, and importantly, none of these discrepancies led to a change in clinical decision. No single examination component was noted to be inconsistent more than twice. Conclusions: These findings support the applicability of the proposed study design to a larger-scale project. No major obstacles or methodological challenges were encountered in achieving the goals of this feasibility study within the target timeframe. This study provides preliminary evidence to support further exploration of the use of virtual consults to help inform clinical decisions in a neurosurgical population.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,024 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».