P2‐053: Telemedicine in a rural memory disorder clinic
Bibliographic record
Abstract
In Canada, the senior population is widely dispersed. Historically, patients have commuted up to 200 km for appointments in Ottawa. Time constraints and poor weather conditions impact on the ability of both patients and geriatricians to attend these clinics. With the growing prevalence of dementia, the waiting lists for follow-up care are growing. In 2006 a rural geriatric telemedicine clinic was implemented to provide follow-up care to patients previously assessed by a geriatrician. This presentation explores the feasibility of introducing a telemedicine memory disorder clinic in a rural community and describes the results of a 3-year evaluation. The geriatrician and assessors (generally nurses) independently rated each video-conference clinic experience. The geriatrician provided details on the specific issues being addressed for each patient, and the assessors indicated why the client was a good candidate for telemedicine and the outcome of the visit. Patients completed an anonymous questionnaire following their session that included their satisfaction ratings on 19 items. Results were collected for 24 clinics held between Nov 2006 and Nov 2009. Clinics lasted approximately 2 hours - on average, 3 patients were seen each time. Set-up, takedown and debriefing took less than 40 minutes for more than half the clinics. Patients generally required reassessment of cognition, follow-up for medications, or follow-up re: driving and/or home safety. Completed surveys were received from 43 patients and 63% indicated that it was their first video session. 95% felt they would be willing to use video-conferencing again and 93% were satisfied with the experience. 25% said that they would still rather see their doctor in person. The physician felt that the session met the patient's needs for 86% of the cases, due to occasional problems with video reception, and patients' difficulty hearing. Telemedicine is an effective way to provide follow-up care for patients with cognitive impairment who would otherwise face a long wait to be seen in a local clinic, or a lengthy and stressful commute for a face-to-face appointment with a geriatrician. Satisfaction with the experience was high among patients, geriatricians and assessors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.012 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".