Browsing by Author "Craig, J"
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- ItemA cohort study of early neurological consultation by telemedicine on the care of neurological inpatients.(2004-06-17) Craig, J; Chua, R; Russell, C; Wootton, R; Chant, D; Patterson, VTo find out the effect of early neurological consultation using a real time video link on the care of patients with neurological symptoms admitted to hospitals without neurologists on site
- ItemCost implications of outpatient teleneurology.(2001-09-28) Chua, R; Craig, J; Wootton, R; Patterson, VA randomized controlled trial was conducted to compare the costs of realtime teleneurology with the cost of conventional neurological care Two district hospitals in Northern Ireland were equipped with videoconferencing units and were connected to the regional neurological centre by ISDN at 384 kbit s Of 168 patients randomized to the study 141 kept their appointments 76 male 65 female Sixty five patients were randomized to a conventional consultation while 76 were randomized to a teleconsultation The average age was 44 years of those seen conventionally and 42 years of those seen by telemedicine The groups had similar diagnoses The telemedicine group required more investigations and reviews than the conventional group The average cost of the conventional consultation was 49 pounds sterling compared with 72 pounds sterling for the teleconsultation Realtime teleneurology was not as cost effective as conventional care
- ItemThe cost-effectiveness of teleneurology consultations for patients admitted to hospitals without neurologists on site. 1: A retrospective comparison of the case-mix and management at two rural hospita...(2000-05-25) Craig, J; Chua, R; Russell, C; Patterson, V; Wootton, RWe are currently evaluating the use of telemedicine for improving the care of patients admitted with neurological symptoms to hospitals that do not have specialist neurologists on site To do this we have been comparing the outcome of patients admitted to two small hospitals In one hospital all patients with neurological symptoms are seen by a neurologist at a distance using an interactive video link transmitting at 384 kbit s in the other patients with neurological problems are managed as per usual practices For the results of this study to be valid it is essential that the case mix and process of management for neurological patients are similar at the two hospitals We therefore compared the case mix process of management and outcome for all patients admitted over a four month period to either hospital who had been coded using ICD 10 as having a final diagnosis of a neurological condition No appreciable differences were noted between the two hospitals for measures of case mix or outcome Likewise most measures of process were similar although there was a significant difference for the overall length of hospital episode between the two hospitals When patients with prolonged hospital episodes were excluded or only patients with a diagnosis of headache epilepsy or transient ischaemic attack were considered who as a group made up the bulk of neurological admissions the difference in the length of hospital episode was not significant It should therefore be possible for us to estimate the effect of telemedicine on the management of patients with neurological problems
- ItemInteractive videoconsultation is a feasible method for neurological in-patient assessment.(2001-02-08) Craig, J; Patterson, V; Russell, C; Wootton, RTo evaluate the feasibility of interactive videoconsultation IATV as a means by which neurologists might assess patients admitted with neurological symptoms to hospitals distant from a neurological centre we studied 25 unselected patients using interactive videoconsultation IATV and then validated the IATV diagnoses and management plans at a later face to face consultation IATV consultation led to an eventual diagnosis in 23 out of 25 patients with one diagnosis being changed and one remaining uncertain The IATV management plans were felt to be appropriate for all patients in study Twelve patients were able to be discharged from hospital on the same day as IATV on the advice of the neurologist It is therefore practical to assess patients admitted with neurological symptoms to distant hospitals using IATV and this may result in more efficient use of in patient resources
- ItemA pilot study of telemedicine for new neurological outpatient referrals.(2000-10-18) Craig, J; Chua, R; Wootton, R; Patterson, VWe investigated whether new patients attending a neurological outpatient clinic could be safely managed by neurologists at a distance using a video link In Northern Ireland a video link transmitting at 384 kbit s was set up between a neurological centre and a small rural hospital 140 km away Twenty five unselected patients who had been referred by their family doctor were assessed by a neurologist using the telemedicine link and then immediately by another neurologist face to face Examiners were blinded to the results of each other s assessment In 24 cases the diagnoses made after the telemedicine and face to face examinations were identical There were minor differences between the type and number of investigations requested and the requirements for treatment and follow up between the two groups Disposal method was the same in 21 of the cases No major organizational difficulties were encountered during the study The study showed that neurologists can deliver outpatient neurological care to distant patients using telemedicine This has the potential to allow access to assessment for the large number of neurological outpatients who might otherwise be denied it
- ItemRandomised controlled trial of telemedicine for new neurological outpatient referrals.(2001-06-19) Chua, R; Craig, J; Wootton, R; Patterson, VTo test the hypothesis that telemedicine for new patient referrals to neurological outpatients is as efficient and acceptable as conventional face to face consultation
- ItemSuccessful management of unexplained coma by telemedicine.(2000-01-20) Patterson, V; Craig, J; Pang, K A; Wootton, R
- ItemUser satisfaction with realtime teleneurology.(2000-07-03) Craig, J; Russell, C; Patterson, V; Wootton, RUser satisfaction i e that of patients medical staff at a remote hospital and medical staff at a neurological centre with realtime teleneurology consultations was studied prospectively Twenty five patients with neurological problems admitted to a hospital without permanent neurological cover were assessed from a neurological centre by specialist neurologists using realtime video links transmitting at 384 kbit s All users reported high levels of satisfaction with the technical aspects of the consultations Patients almost universally reported confidence in teleneurology as a means of dealing with their presenting complaints Similarly medical staff at either site felt confident in managing patients using teleneurology and almost always felt that a telephone consultation would not have achieved as good an outcome No major organizational problems were identified These findings suggest overall user satisfaction with realtime teleneurology for managing patients with neurological problems admitted to hospitals that do not have resident neurologists