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Abstract Details

Accuracy of Clinical Assessments with Virtual Care in an Outpatient Neurological Setting
Practice, Policy, and Ethics
P1 - Poster Session 1 (8:00 AM-9:00 AM)
10-003
Virtual neurological assessments were increasingly used and an important viable option during the COVID-19 pandemic. However, the accuracy of such assessments is unknown when the neurological examination is not performed in person.

To analyze the accuracy of video and telephone consultations in the setting of an outpatient neurology clinic when compared to in person office assessments. 

Clinical records were reviewed in a predominant MS outpatient clinic at an academic teaching hospital from March 23rd 2020 to March 23rd 2021 during the COVID-19 pandemic.  Patients assessed during this period were analyzed with an initial virtual assessment and compared to in person evaluations when restrictions were lifted or on an urgent basis. “Clinical disparity (DISP)” was defined as: (a) patients reporting progression virtually, but found no significant changes on exam with an alternative explanation for complaints, (b) patients reporting stability virtually, but there were significant changes on the exam.

1036 out of 1484 patients were included in this study who had both virtual and in person assessments. 27.8% (n=288) of consultations were video and 72.2% (n=748) telephone. A total of 13.8% (n=143) of virtual consultations revealed DISP, specifically 13.5% (n=39) video and 13.9% (n=104) telephone consultations. Of all the 1036 cases, 2.32% (n=24) patients stated they were stable but significant changes were seen on exam, changing the clinical impression. 11.5% (n=119) of patients stated they were deteriorating virtually but was not confirmed with in person assessment, with alternative explanation.

Virtual assessments were accurate in over 85% of the outpatient neurological cases during the pandemic. However, the in person neurological exam led to a change in clinical opinion in 13.8% of assessments. 2.32% patients described clinical stability, but clinical management was altered when significant exam findings were identified, including subtle weaknesses, abnormal reflexes, sensory changes, not identified virtually.

Authors/Disclosures
Julia Pellegrino
PRESENTER
Ms. Pellegrino has nothing to disclose.
Liesly Lee, MD (Sunnybrook Health Sciences Centre) Dr. Lee has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Lee has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Lee has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi-Aventis. Dr. Lee has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Lee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Lee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Lee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Lee has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis.