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Remote Assessment of Stroke Severity With Head-Mounted Computer
Lower Lobby
Remote Assessment of Stroke Severity With Head-Mounted Computer
University of Pennsylvania
BackgroundTelemedicine (TM) is a valuable resource when vascular neurologists are not locally available. Yet, the high infrastructure and startup costs and lack of portability associated with traditional... Read more

Description

Background
Telemedicine (TM) is a valuable resource when vascular neurologists are not locally available. Yet, the high infrastructure and startup costs and lack of portability associated with traditional TM devices may limit its use. Head-mounted computers (HMC), equipped with front-facing cameras, offer potential advantages to traditional TM, including a first-person perspective, hands-free portability, and lower equipment costs. However, feasibility of HMC’s in stroke assessment has not been assessed.

Methods
Eight patients with clinical diagnosis of stroke were assessed using the National Institutes of Health Stroke Scale (NIHSS). Each examination was performed by an investigator at the bedside while wearing the Vuzix M100 Smartglasses, an Android-based HMC with front-facing camera and monocular display. Through a wireless tablet, a remote examiner can view and communicate with the bedside examiner through the HMC via a HIPAA-compliant software platform created by Third Eye Health. Interrater agreement was assessed using Kappa statistics for each item on the NIHSS. Excellent agreement was defined as Kappa >0.75, moderate as 0.4-0.75, and poor as

Results
Average NIHSS score (Table 1) was similar between bedside (7.63, range 0-26) and remote examiners (7.88, range 0-28). Breakdown and degree of agreement for each NIHSS item is shown in Table 2. The questions, visual fields, facial droop, left arm, right leg, and aphasia items showed excellent agreement. Moderate agreement was seen in the level of consciousness, gaze, right arm, left leg, ataxia, and dysarthria. Poor agreement was seen in commands, sensory, and neglect. Intraclass correlation coefficient for total NIHSS was high between bedside and remote examiner (0.9961; 95% CI 0.9826-0.9992), indicating high level of agreement.

Conclusions
These initial results suggest that a HMC is a feasible method to assess stroke severity, and may be a cheaper, more portable, hands-free alternative to traditional TM. Our study is limited by small sample size; enrollment is ongoing.

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