A comparison of epilepsy patients in a traditional ambulatory clinic and a telemedicine clinic.

PURPOSE: This article compares a traditional ambulatory clinic in an academic medical center with a telemedicine clinic. The telemedicine clinic is a joint project of the UTMB Telehealth Center and the Epilepsy Foundation of Southeast Texas, with partial funding for clinical operations provided by the Texas Department of Health. METHODS: Data were collected on all the patients (n = 155) in both clinics for 3 months in 2004. In addition to demographic information, outcome data (number of seizures, hospitalizations, and emergency room visits) were gathered. Medication compliance also was collected by using self-report and medication levels. RESULTS: Outcome variables were subjected to t test and chi(2) analysis. No significant differences were found in any of the demographic data or outcome measures between the two groups. CONCLUSIONS: Telemedicine is an acceptable alternative to in-person clinics for the provision of care to adults with epilepsy. Because telemedicine programs are designed to bring medical care closer to where patients live, these clinics provide an excellent alternative to provide consistent care in rural and geographically isolated areas. Additional studies are needed to investigate the potential costs associated with telemedicine as well as the potential for cost savings over time as patients are more able to access care and therefore may be more likely to seek the needed routine care and follow-up.

Introduction of patient video clips into computer-based testing: effects on item statistics and reliability estimates.

PURPOSE: Using patient video clips to evaluate examinees' skills in interpreting physical examination findings is possible with computer-based testing, but the psychometric properties of video-based questions are unknown. METHOD: We developed parallel test questions incorporating video clips or text descriptions of abnormal neurologic findings and administered them to 106 fourth-year medical students finishing their Neurology Clerkship. RESULTS: Overall, video-based questions had comparable difficulty and discrimination compared to analogous text-based questions. Preliminary studies indicated similar reliability with text- and video-based questions. CONCLUSIONS: The inclusion of patient video clips in computer-based testing is feasible from technical, practical, and psychometric perspectives. Further study is needed to gather validity evidence for this novel question format.