Home Videos as a Cost-Effective Tool for the Diagnosis of Paroxysmal Events in Infants: Prospective Study

Abstract

Background The diagnosis of paroxysmal events in infants is often challenging. Reasons include the child’s inability to express discomfort and the inability to record video electroencephalography at home. The prevalence of mobile phones, which can record videos, may be beneficial to these patients. In China, this advantage may be even more significant given the vast population and the uneven distribution of medical resources. Objective The aim of this study is to investigate the value of mobile phone videos in increasing the diagnostic accuracy and cost savings of paroxysmal events in infants. Methods Clinical data, including descriptions and home videos of episodes, from 12 patients with paroxysmal events were collected. The investigation was conducted in six centers during pediatric academic conferences. All 452 practitioners present were asked to make their diagnoses by just the descriptions of the events, and then remake their diagnoses after watching the corresponding home videos of the episodes. The doctor’s information, including educational background, profession, working years, and working hospital level, was also recorded. The cost savings from accurate diagnoses were measured on the basis of using online consultation, which can also be done easily by mobile phone. All data were recorded in the form of questionnaires designed for this study. Results We collected 452 questionnaires, 301 of which met the criteria (66.6%) and were analyzed. The mean correct diagnoses with and without videos was 8.4 (SD 1.7) of 12 and 7.5 (SD 1.7) of 12, respectively. For epileptic seizures, mobile phone videos increased the mean accurate diagnoses by 3.9%; for nonepileptic events, it was 11.5% and both were statistically different (P=.006 for epileptic events; P<.001 for nonepileptic events). Pediatric neurologists with longer working years had higher diagnostic accuracy; whereas, their working hospital level and educational background made no difference. For patients with paroxysmal events, at least US $673.90 per capita and US $128 million nationwide could be saved annually, which is 12.02% of the total cost for correct diagnosis. Conclusions Home videos made on mobile phones are a cost-effective tool for the diagnosis of paroxysmal events in infants. They can facilitate the diagnosis of paroxysmal events in infants and thereby save costs. The best choice for infants with paroxysmal events on their initial visit is to record their events first and then show the video to a neurologist with longer working years through online consultation.

Clinical utility of home videos for diagnosing epileptic seizures: a systematic review and practical recommendations for optimal and safe recording

“…Table 1 displays the 17 identified studies [10][11][12][13][17][18][19][20][21][22][23][24][25][26][27][28][29] and case reports that have included clinical application of home/ smartphone videos in diagnosing PSLE. Studies were carried out in North America, Europe, and Asia.…”

“…In the present era of smartphone devices which are ubiquitous in society [9], there is a crescent interest in the potential role of home video recordings (HVRs) in supporting the diagnosis of epilepsy. Several studies have already highlighted their non-inferiority to VEEG monitoring to diagnose epilepsy [10][11][12][13], and many examples already exist of smartphone applications that aid physicians in clinical decision-making and optimal management of patients with epilepsy [14,15]. However, there is no consensus on quality standards and safety recommendations for HVRs.…”

Seizure‐like events leading to hospital referrals in infants: A retrospective population‐based study

“…Home videos have been shown to be a cost-effective contribution to the diagnosis of paroxysmal events in infants. 29 They were not used systematically in this study, but should be noted as a valuable supplement to clarify descriptions of paroxysmal events. 29 Further research is needed to determine whether using home videos, together with the findings of this study, could reduce overall health care need including advanced examinations in infants with paroxysmal events.…”

“…Home videos have been shown to be a cost‐effective contribution to the diagnosis of paroxysmal events in infants 29 . They were not used systematically in this study, but should be noted as a valuable supplement to clarify descriptions of paroxysmal events 29 …”

Is it really a seizure? The challenge of paroxysmal nonepileptic events in young infants

“…Using video recordings to verify the symptoms enhances not only the diagnostic accuracy but is also cost-effective. 37) Moreover, birth history, past history (trauma, chronic illness, etc.) and family history need to be considered.…”