Introduction:

Childhood epilepsy forms a significant burden on the health-care delivery system. Telemedicine is a proposed effective alternative in overcoming this burden.

Methods:

Tele-consultation by a DM Pediatric Neurology Fellow was compared with that of a Specialty Nurse; both against Face-to-Face consultation (gold standard). Care-givers of children 4 months-18 years with epilepsy were telephonically consulted 24-48hours before their scheduled hospital appointment by one Specialty Nurse and one DM pediatric Neurology Fellow at least 24 hours apart in a random sequence. During the hospital visit, another DM Pediatric Neurology Fellowblinded to the telephonic consultation, documented the same after Face- to- Face interview. A predesigned proforma was used to identify Critical Clinical Events related to the disease, drugs, compliance and adverse events.

Results:

In 141 children with epilepsy, 504 events were identified. Tele-consultation by DM Pediatric Neurology Fellow had a sensitivity of 98%; specificity of 100%; negative predictive value (NPV) of 90%; positive predictive value (PPV) of 98%, negative likelihood ratio (NLR)of 0.01 and accuracy of 90% in identifying critical events as compared to face to face consultation. Tele-consultation by Specialty Nurse had a sensitivity of 79%; specificity of 73%; NPV of 90%; PPV of 95%, positive likelihood ratio of 3.24, NLR of 0.08 and accuracy of 78%  in identifying Critical Clinical Events as compared to Face-to-Face consultation.

Conclusions:

Tele-consultation in childhood epilepsy by DM Pediatric neurology Fellow has excellent sensitivity and specificity and by Specialty Nurse has also acceptable sensitivity and specificity in comparison with Face-to-Face consultation.