{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:19:14Z","timestamp":1789521554027,"version":"build-2803163510"},"reference-count":21,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The accuracy of diagnosing acute cerebrovascular disease via a teleneurology service and the characteristics of misdiagnosed patients are insufficiently known. Methods: A random sample (n = 1500) of all teleneurological consultations conducted between July 2015 and December 2017 was screened. Teleneurological diagnosis and hospital discharge diagnosis were compared. Diagnoses were then grouped into two main categories: cerebrovascular disease (CVD) and noncerebrovascular disease. Test characteristics were calculated. Results: Out of 1078 consultations, 52% (n = 561) had a final diagnosis of CVD. Patients with CVD could be accurately identified via teleneurological consultation (sensitivity 95.2%, 95% CI 93.2\u201396.8), but we observed a tendency towards false-positive diagnosis (specificity 77.4%, 95% CI 73.6\u201380.8). Characteristics of patients with a false-negative CVD diagnosis were similar to those of patients with a true-positive diagnosis, but patients with a false-negative CVD diagnosis had ischemic heart disease less frequently. In retrospect, one patient would have been considered a candidate for intravenous thrombolysis (0.2%). Conclusions: Teleneurological consultations are accurate for identifying patients with CVD, and there is a very low rate of missed candidates for thrombolysis. Apart from a lower prevalence of ischemic heart disease, characteristics of \u201cstroke chameleons\u201d were similar to those of correctly identified CVD patients.<\/jats:p>","DOI":"10.3390\/jcm10061170","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T05:38:22Z","timestamp":1615441102000},"page":"1170","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Diagnostic Accuracy in Teleneurological Stroke Consultations"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8742-0694","authenticated-orcid":false,"given":"Jordi","family":"K\u00fchne Escol\u00e0","sequence":"first","affiliation":[{"name":"Department of Neurology, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Nagel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Verez Sola","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2404-3473","authenticated-orcid":false,"given":"Eva","family":"Doroszewski","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Jaschonek","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Gutschalk","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Gumbinger","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2978-4972","authenticated-orcid":false,"given":"Jan C.","family":"Purrucker","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1016\/S0140-6736(14)60584-5","article-title":"Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: A meta-analysis of individual patient data from randomised trials","volume":"384","author":"Emberson","year":"2014","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1001\/jama.2016.13647","article-title":"Time to Treatment With Endovascular Thrombectomy and Outcomes From Ischemic Stroke: A Meta-analysis","volume":"316","author":"Saver","year":"2016","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1197\/j.aem.2004.08.014","article-title":"Virtual TeleStroke Support for the Emergency Department Evaluation of Acute Stroke","volume":"11","author":"Schwamm","year":"2004","journal-title":"Acad. 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