Clinical Trials |

Randomized Controlled Clinical Trial of “Virtual House Calls” for Parkinson Disease

E. Ray Dorsey, MD, MBA; Vinayak Venkataraman, BS; Matthew J. Grana, BA; Michael T. Bull, BS; Benjamin P. George, MPH; Cynthia M. Boyd, MD, MPH; Christopher A. Beck, PhD; Balaraman Rajan, MBA, MS; Abraham Seidmann, PhD; Kevin M. Biglan, MD, MPH
JAMA Neurol. 2013;70(5):565-570. doi:10.1001/jamaneurol.2013.123.
Text Size: A A A
Published online

Importance The burden of neurological disorders is increasing, but access to care is limited. Providing specialty care to patients via telemedicine could help alleviate this growing problem.

Objective To evaluate the feasibility, effectiveness, and economic benefits of using web-based videoconferencing (telemedicine) to provide specialty care to patients with Parkinson disease in their homes.

Design A 7-month, 2-center, randomized controlled clinical trial.

Setting Patients' homes and outpatient clinics at 2 academic medical centers.

Participants Twenty patients with Parkinson disease with Internet access at home.

Intervention Care from a specialist delivered remotely at home or in person in the clinic.

Main Outcome Measures The primary outcome variable was feasibility, as measured by the percentage of telemedicine visits completed as scheduled. Secondary outcome measures included clinical benefit, as measured by the 39-item Parkinson Disease Questionnaire, and economic value, as measured by time and travel.

Results Twenty participants enrolled in the study and were randomly assigned to telemedicine (n = 9) or in-person care (n = 11). Of the 27 scheduled telemedicine visits, 25 (93%) were completed, and of the 33 scheduled in-person visits, 30 (91%) were completed (P = .99). In this small study, the change in quality of life did not differ for those randomly assigned to telemedicine compared with those randomly assigned to in-person care (4.0-point improvement vs 6.4-point improvement; P = .61). Compared with in-person visits, each telemedicine visit saved participants, on average, 100 miles of travel and 3 hours of time.

Conclusion and Relevance Using web-based videoconferencing to provide specialty care at home is feasible, provides value to patients, and may offer similar clinical benefit to that of in-person care. Larger studies are needed to determine whether the clinical benefits are indeed comparable to those of in-person care and whether the results observed are generalizable.

Trial Registration clinicaltrials.gov Identifier: NCT01476306

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours


Place holder to copy figure label and caption
Graphic Jump Location

Figure. Flowchart of the screening and enrollment of 20 study participants with Parkinson disease who were randomly assigned to telemedicine or in-person care.





You need to register in order to view this quiz.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 4

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles

The Rational Clinical Examination
Make the Diagnosis: Parkinsonism

The Rational Clinical Examination
Original Article: Does This Patient Have Parkinson Disease?