Telephone visit efficacy for Parkinson’s disease during the COVID-19 pandemic
Bibliographic record
Abstract
"1. Introduction There has been growing interest in using telemedicine to expand accessibility of patients with Parkinson’s disease (PD) to clinical care. Efficacy of telemedicine visits continues to be evaluated [1], [2], [3]. During the COVID-19 pandemic, there was an abrupt transition from in-person to remote visits [4]; in our center, due to regulatory and practical barriers, this was conducted by telephone. This abrupt externally-induced and near-complete transition provided an opportunity to directly compare telephone and in-person visits, independent of factors related to patient choice of intervention. Therefore, we explored whether the absence of face-to-face interactions would alter the frequency of changes in medical therapy. We reviewed medical records of 100 PD patients followed at McGill Movement disorders clinic who had a telephone visit March-May 2020 (convenience sample) plus at least one prior in-person visit within 12 months. The project was approved by the local institutional review board; waiver of Informed Consent was granted due to the study’s retrospective nature. The primary outcome was the proportion of visits which ended in a change of therapy. We used the chi-square test and logistic regression for comparison of categorical variables. The population was 40% female, age = 72 ± 10.1 years (Table 1). The average time between the two consecutive visits was similar between telemedicine and in-person visits (5.97 ± 2.1 vs. 6.03 ± 2.3 months). Overall, we observed fewer medication changes during telephone visits; a change was made in 44% of telemedicine visits compared to 59% of the preceding in-person visit [OR 1.83, 95%CI: 1.05–3.21]. This reduction was particularly evident for starting a new medication (new motor medication = OR 3.27[95%CI: 1.02–10.52], new non-motor medication = OR 3.62[95%CI: 1.27–10.3]). Patients in telemedicine visits were less often referred for outside consultation (0% telemedicine vs. 5% in-person, p = 0.024). There was a modest nonsignificant reduction dose changes of existing treatments in telemedicine visits (motor [OR 1.28, 95%CI: 0.73–2.24], non-motor OR 1.83, 95%CI: 0.84–3.99])."@eng
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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 | 0.002 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 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".