Systematic review of teleneurology: methodology.

BackgroundThe use of two-way audio-visual technology for delivery of acute stroke is supported by a well established literature base. The use of telemedicine for general neurologic consultation has been reported across most subspecialties within the field, but a comprehensive systematic review of these reports is lacking.PurposeTo conduct a systematic review of the published literature on teleneurologic consultation beyond stroke.Data sourcesDatabases Ovid MEDLINE, EMBASE, PsychINFO, CINAHL, and Cochrane were searched with keywords, "teleneurology," and numerous synonyms and cross-referenced with neurology subspecialties. The search yielded 6,615 potentially eligible hits, which were independently reviewed by two investigators. Ultimately 375 unique studies met eligibility criteria and were included in the review.Study selectionStudies were included if the title or abstract expressed use of two-way AV communication for a clinical neurologic indication other than stroke.Data extractionEach article was classified using a novel scoring rubric to assess the level of functionality, application, technology, and evaluative stage.Data analysisArticles were hierarchized within a subspecialty category. Overall subspecialty scores were assigned based on aggregate of scores across papers in each category.ConclusionUse of telemedicine for general and most subspecialty neurologic consultation, beyond stroke, appears very promising but the clinical science is nascent.