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Medical information is now widely available on the Internet and through telephone helplines such as NHS Direct and the focus on patient self care is likely to increase. Clinicians in all specialties will often encounter patients who have made self-directed searches for medical information prior to the clinical encounter. Teleneurology by Internet and Telephone is a study of patient information-seeking behaviour in neurology patients prior to referral from primary to secondary care. The book analyses frequency of Internet access and use, and of telephone helpline awareness and use. It also explores use of these modalities over time, use according to patient gender and age and by gender and age over time. Teleneurology by Internet and Telephone is an accessible overview of the utility of these modalities of health information provision and will be of interest not only to neurologists and clinicians in other specialities but also to public health researchers, sociologists and political scientists with an interest in questions of health care provision.
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
This concise, pragmatic, pocket-sized book addresses neurological contributions to the diagnosis and management of dementia through a longitudinal examination of the work undertaken in a dedicated neurological dementia clinic. It covers the use of cognitive and non-cognitive screening instruments and their diagnostic utility and the use of other diagnostic investigations: neuroimaging, neurophysiology and neuropathology. The diagnostic mix is discussed in terms of both neuropsychological syndromes and neurological diagnoses, as is the use of conventional treatments for dementia and the impact of national directives (e.g. NICE, National Dementia Strategy) on day-to-day clinical practice. Dementia in Clinical Practice: A Neurological Perspective, Second Edition is an illustrated, practical resource for medical professionals involved in the assessment and management of dementia patients. It is of particular benefit to neurologists, psychiatrists, geriatricians, primary care practitioners and those working in the fields of neuropsychology, psychology, occupational therapy, speech and language therapy and nursing.
In today's changing medical climate, more physicians than ever before are incorporating telemedicine into their clinical practice. TeleNeurology provides comprehensive, practical answers to the many questions clinicians have on implementing and growing a teleneurology practice. Covering everything from historical perspectives to future possibilities in this evolving field, it provides the information you need to successfully use this promising new option in providing optimal and adaptable patient care. - Covers all aspects of practical implementation including technology requirements, legal requirements, and billing concerns. - Provides a thorough discussion of how to perform a neurological exam via telemedicine, including links to view real-world examples and find updated regulatory information. - Reviews teleneurological evaluation for various disorders including stroke, epilepsy, and movement disorders.
This book presents and discusses the numerous measures of test performance that can be derived from 2x2 tables. Worked examples based on pragmatic test accuracy study data are used in chapters to illustrate relevance to day-to-day clinical practice. Readers will gain a good understanding of sensitivity and specificity and predictive values along with many other parameters. The contents are highly structured and the use of worked examples facilitates understanding and interpretation. This book is a resource for clinicians in any discipline who are involved in the performance or assessment of test accuracy studies, and professionals in the disciplines of machine learning or informatics wishing to gain insight into clinical applications of 2x2 tables.
The new and updated edition of this book explains the key steps in planning and executing diagnostic test accuracy studies in dementia, serving as an introduction to the topic with clear explanations of difficulties and pitfalls. It has been fully revised in light of developments over the past 5 years and includes STARD publications which have appeared since the first edition as well as the use of biomarkers of cognitive disorders as increasingly enshrined in diagnostic criteria. The book covers the presentation of study results in terms of measures of discrimination, taking examples from studies in dementia looking at various diagnostic methods including cognitive instruments, neuroimaging, and biochemical studies. The book continues to reflect the author’s own experience in diagnostic test accuracy studies, particularly in the sphere of cognitive screening instruments.. Diagnostic Test Accuracy Studies in Dementia encourages clinicians to adopt a pragmatic approach to diagnostic test accuracy studies rooted in day-to-day clinical practice.
"Teleneurology" refers to the use of telecommunications techniques such as the telephone, Internet, email, and videoconferencing to improve the delivery of neurology services. Containing 15 contributions from international clinicians, this volume provides an introduction to telemedicine as it is practiced in neurology today. It is divided into three sections: techniques, applications, and practical issues. Technical information has been kept to a minimum, as the emphasis is on the utility of each technique, rather than the technology itself. The editors are affiliated with the Center for Online Health at the U. of Queensland in Australia. Annotation :2005 Book News, Inc., Portland, OR (booknews.com).
This title will provide an up-to-date review of the emerging practice of neurology telemedicine. Increasingly, neurology, like other disciplines of medicine, is implementing the technological advances and discoveries of the science of healthcare delivery to improve not only access and efficiency but outcomes and cost as well. For patients in remote and underserved areas, having a neurological condition means lengthy and costly travel to obtain specialist evaluation. Telemedicine has the ability to deliver such care to a patient’s local community. Neurology telemedicine for acute stroke has already demonstrated clinical efficacy and cost effectiveness by raising the numbers of thrombolysis-eligible patients who can be treated in a timely fashion. More than 85% of leading US neurology departments currently use or plan to implement telemedicine within the next year. The US military has a limited number of neurologists – a store-and-forward consultation system has enabled military neurologists to deliver far-forward battlefield care for service members deployed overseas. The chapters in this book will review the use of telemedicine for the evaluation and treatment of patients with many common neurological conditions and will provide a practical guide for neurologists seeking to incorporate telemedicine into their daily practices.
This book draws on the author’s experience in conducting pragmatic test accuracy studies on screening instruments for dementia/mild cognitive impairment. To facilitate comprehension and assimilation, all data is presented in an easily accessible, succinct and user-friendly way by means of a structured tabular format that allows tests to be easily compared. The pragmatic design of studies ensures high external validity and generalizability for the test results. The book includes a wealth of data on previously presented studies, as well as hitherto unreported test measures (“Number needed” metrics). It presents recently described and new diagnostic metrics (Likelihood to be diagnosed or misdiagnosed; Summary utility index; Number needed for screening utility); data from new studies on screeners (Attended with sign; Free-Cog; Two question depression screener; Jenkins Sleep Questionnaire; Triple test); and previously unpublished data (combination of SMC Likert and MACE; IADL Scale and MMSE). Given its scope, the book will be of interest to all professionals, beginners and seasoned experts alike, whose work involves the assessment of individuals with cognitive (memory) complaints.
This issue is a dedicated supplement published in addition to the regular issues of 'Cerebrovascular Diseases' focussing on one specific topic. 'Cerebrovascular Diseases' is a well-respected, international peer-reviewed journal in Neurology. Supplement issues are included in the subscription.