Diagnostic accuracy of and patient satisfaction with telemedicine for the follow-up of paediatric burns patients

Videoconferencing has become a routine technique for the post-acute burns care of children in Queensland. We compared the agreement between clinical assessments conducted via videoconference and assessments conducted in the conventional, face-to-face manner (FTF). A total of 35 children with a previous burn injury were studied. Twenty-five children received three consecutive assessments: first FTF by a consultant in the outpatient department, then by a second consultant who reviewed the patient via videoconference, and then by the second consultant in person. The second consultant also reviewed another 10 children twice. At each review, the following variables were measured: scar colour, scar thickening, contractures, range of motion, the patient's level of general activity, any breakdown of the graft site, and adequacy of the consultation. Agreement between the two consultants when seeing patients FTF was moderately high, with an overall concordance of 85%. When videoconferencing was used, the level of agreement was almost the same, at 84%. If one consultant reviewed patients FTF first and then via videoconference, the overall concordance was 98%; if the process was reversed, the overall concordance was 97%. This study confirms that the quality of information collected during a videoconference appointment is comparable to that collected during a traditional, FTF appointment for a follow-up burns consultation.

Virtual teams and group member dissimilarity - Consequences for the development of trust

The consequences of demographic dissimilarity for group trust in work teams was examined in a virtual (computer-mediated) and a face-to-face (FTF) environment. Demographic dissimilarity (based on age, gender, country of birth, enrolled degree) was predicted to be negatively associated with group trust in the FTF environment but not in the computer-mediated environment. Participants worked in small groups on a creative task for 3 consecutive days. In the computer-mediated environment, participants worked on the task for an hour per day. In the FTF environment, participants worked on the task for 20 minutes per day. Partial support was found for the effectiveness of computer-mediated groups in reducing the negative consequences of dissimilarity. Age dissimilarity was negatively related to trust in FTF groups but not in computer-mediated groups. Birthplace dissimilarity was positively related to trust in computer-mediated groups. Implications for the successful management of virtual teams are discussed.

Assessment of motor speech disorders online: A pilot study

We have conducted a preliminary validation of an Internet-based telehealth application for assessing motor speech disorders in adults with acquired neurological impairment. The videoconferencing module used NetMeeting software to provide realtime videoconferencing through a 128 kbit/s Internet link, as well as the transfer of store-and-forward video and audio data from the participant to the clinician. Ten participants with dysarthria following acquired brain injury were included in the study. An assessment of the overall severity of the speech disturbance was made for each participant face to face (FTF) and in the online environment, in addition, a 23-item version of the Frenchay Dysarthria Assessment (FDA) (which measures motor speech function) and the Assessment of Intelligibility of Dysarthric Speech (ASSIDS) (which gives the percentage word and sentence intelligibility, words per minute and a rating of communication efficiency) were administered in both environments. There was a 90% level of agreement between the two assessment environments for the rating of overall severity of dysarthria. A 70-100% level of agreement was achieved for 17 (74%) of the 23 FDA variables. On the ASSIDS there was a significant difference between the FTF and online assessments only for percentage word intelligibility. These findings suggest that Internet-based assessment has potential as a reliable method for assessing motor speech disorders.