{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T13:00:58Z","timestamp":1782997258127,"version":"3.54.5"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>The adoption of telemedicine is generally considered as advantageous for patients and physicians, but there is limited rigorous assessment of examination strengths and limitations. We set out to perform a quantitative assessment of the limitations of a standardized examination of subjects with myasthenia gravis (MG) during video\u2010taped telemedicine sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We utilized a video bank containing recordings from 51 MG patients who completed two telemedicine\u2010based examinations with neuromuscular experts; each recording included the MG core examination (MG\u2010\n                      <jats:sc>CE<\/jats:sc>\n                      ) and the MG activities of daily living (MG\u2010ADL). We then applied artificial intelligence (AI) algorithms from computer vision and speech analysis to natural language processing to generate and assess the reproducibility and inter\u2010rater reliability of the MG\u2010\n                      <jats:sc>CE<\/jats:sc>\n                      and MG\u2010ADL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We successfully developed a technology to assess video examinations. While overall MG\u2010\n                      <jats:sc>CE<\/jats:sc>\n                      scores were consistent across examiners, individual metrics showed significant variability, with up to a 25% variation in scoring within the MG\u2010\n                      <jats:sc>CE<\/jats:sc>\n                      's range. Additionally, there was wide variability in adherence to MG\u2010ADL instructions. These variations were attributed to differences in examiner instructions, video recording limitations, and patient disease severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>\n                      We were able to develop a system of digital analysis of neuromuscular examinations in order to assess variability in individual scoring measures of the MG\u2010ADL and MG\u2010\n                      <jats:sc>CE<\/jats:sc>\n                      . Our approach enabled post hoc quantitative analysis of neuromuscular examinations. Further refinement of this technology could enhance examiner training and reduce variability in clinical trial outcome measures.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.28394","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T03:17:11Z","timestamp":1743650231000},"page":"34-41","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Quantitative Study of Factors Influencing Myasthenia Gravis Telehealth Examination Score"],"prefix":"10.1002","volume":"72","author":[{"given":"Marc","family":"Garbey","sequence":"first","affiliation":[{"name":"Department of Surgery, School of Medicine &amp; Health Sciences George Washington University  Washington District of Columbia USA"},{"name":"Laboratoire Des Sciences de l'Ing\u00e9nieur Pour l'Environnement (LaSIE) UMR\u2010CNRS 7356 University of La Rochelle  La Rochelle France"},{"name":"Care Constitution Corp  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Lesport","sequence":"additional","affiliation":[{"name":"Laboratoire Des Sciences de l'Ing\u00e9nieur Pour l'Environnement (LaSIE) UMR\u2010CNRS 7356 University of La Rochelle  La Rochelle France"},{"name":"Care Constitution Corp  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Girma","sequence":"additional","affiliation":[{"name":"Department of Neurology &amp; Rehabilitation George Washington University  Washington DC United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1638-9095","authenticated-orcid":false,"given":"G\u00fcl\u015fen","family":"\u00d6ztosun","sequence":"additional","affiliation":[{"name":"Department of Neurology &amp; Rehabilitation George Washington University  Washington DC United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8195-0141","authenticated-orcid":false,"given":"Henry J.","family":"Kaminski","sequence":"additional","affiliation":[{"name":"Department of Neurology &amp; Rehabilitation George Washington University  Washington DC United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/picr.picr_219_22"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/s24082546"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010023\u201002459\u20105"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1144183"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102022\u2010068104"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27742"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207278"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27260"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2196\/43387"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/s23187744"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1474884"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.7.1487"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.22140"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3233\/JND\u2010200484"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23330"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1109\/WI-IAT59888.2023.00065"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10462\u2010022\u201010144\u20101"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.28394","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T03:19:14Z","timestamp":1749093554000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.28394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,2]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/mus.28394"],"URL":"https:\/\/doi.org\/10.1002\/mus.28394","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2024.07.24.24310934","asserted-by":"object"}]},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,2]]},"assertion":[{"value":"2024-05-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}