{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T02:48:55Z","timestamp":1785898135801,"version":"3.56.0"},"reference-count":50,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["RF\u20102016\u201002364742"],"award-info":[{"award-number":["RF\u20102016\u201002364742"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This study aimed at assessing the inter\u2010procedural reliability (compared to the in\u2010office consultation) and the diagnostic accuracy (compared to the reference standard) of the telemedicine consultation to guide the diagnostic workup of adults and children when complaint of excessive daytime sleepiness, possibly due to narcolepsy, is suspected. A cross\u2010sectional diagnostic study was initiated in 2019 and completed in 2023. Consecutive people of any age referred for excessive daytime sleepiness complaint to the Clinic for Narcolepsy in Bologna were eligible for inclusion. The telemedicine consultation was conducted via tablet for the patient and via equipped personal computer in another room for the physician (interviewer). Interviewers expressed diagnostic orientation indicating narcolepsy as \u2018probable\u2019, \u2018possible\u2019 and \u2018excluded\u2019. The final diagnosis was established by applying the International Classification of Sleep Disorders criteria. Inter\u2010procedural reliability and diagnostic accuracy measures were calculated. Two hundred and twenty\u2010one participants were included in the reliability study, 198 in the diagnostic accuracy study. The agreement between the two consultation modalities on diagnostic orientation was \u2018substantial\u2019 (Kappa 0.74, 95% CI 0.66\u20130.82). Agreement on the presence of narcoleptic pentad symptoms was \u2018substantial\u2019 (excessive daytime sleepiness, hypnagogic hallucinations, disrupted nocturnal sleep) or \u2018almost perfect\u2019 (cataplexy, sleep paralysis). In children reliability for excessive daytime sleepiness, cataplexy and hypnagogic hallucinations was lower. Telemedicine and in\u2010office consultation had identical sensitivity (100%, 95% CI 94\u2013100) and similar specificity (43%, 95% CI 35\u201352, vs. 40%, 95% CI 32\u201349). Telemedicine consultation is a reliable diagnostic triage procedure when excessive daytime sleepiness possibly due to narcolepsy is suspected, in particular to exclude people who do not suffer from narcolepsy without the risk of false negatives.<\/jats:p>","DOI":"10.1111\/jsr.70417","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T02:26:39Z","timestamp":1785896799000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Telemedicine Consultation as Diagnostic Triage for Adult and Children With Suspected Narcolepsy: A Reliability and Diagnostic Accuracy Study"],"prefix":"10.1111","author":[{"given":"Luca","family":"Vignatelli","sequence":"first","affiliation":[{"name":"IRCCS Istituto Delle Scienze Neurologiche di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Pizza","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Delle Scienze Neurologiche di Bologna  Bologna Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) Alma Mater Studiorum University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Vandi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Delle Scienze Neurologiche di Bologna  Bologna Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) Alma Mater Studiorum University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Baccari","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Delle Scienze Neurologiche di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Zenesini","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Delle Scienze Neurologiche di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5194-375X","authenticated-orcid":false,"given":"Francesca","family":"Ingravallo","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1051-0472","authenticated-orcid":false,"given":"Giuseppe","family":"Plazzi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Delle Scienze Neurologiche di Bologna  Bologna Italy"},{"name":"Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio\u2010Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"ICSD\u20103 TR: International Classification of Sleep Disorders","author":"American Academy of Sleep Medicine","year":"2023"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsaf165"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7549.1089"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h5527"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102022\u2010068207"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j3751"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.29958"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1258\/jtt.2009.003003"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1002\/0471445428.ch3","volume-title":"Statistical Methods for Rates and Proportions","author":"Fleiss J.","year":"2003"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsaa044"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.08.024"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325\u2010021\u201002292\u20105"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2012.08.002"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883\u2010020\u201001762\u20109"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2019.10.013"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2012.06.006"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.03.002"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2021.101543"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2020.101306"},{"issue":"1","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The Measurement of Observer Agreement for Categorical Data","volume":"33","author":"Landis J. 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