The Coronavirus disease 2019 (COVID-19) pandemic forced a shift to virtual care within many neurological care settings. Little is known about the validity of the VNE for clinical decision-making compared to the IPNE. This study will provide further insight into the value of the VNE in the outpatient setting.

A retrospective chart review is being conducted of patients who were evaluated and examined virtually and in-person within 4 months in the outpatient general neurology, cognitive neurology, neuromuscular, and stroke clinics at two tertiary care centers at the University of Toronto during the COVID-19 pandemic. Descriptive statistical methods are used to compare virtual and in-person assessment results, accuracy, localization, diagnosis, investigations and management approaches.

Preliminary comparison of 10 patients from the neuromuscular clinic at St. Michael’s Hospital, showed only 2 cases where the localization changed after the IPNE. Interestingly, in both cases, the additional findings on the IPNE, not documented on the VNE, were unrelated to the reason for referral. In 4 cases, the IPNE provided increased diagnostic certainty, but did not change the leading differential diagnosis after the virtual assessment. In the remaining 6 cases, the diagnosis made after both virtual and in-person assessments were unchanged.

The study is ongoing, and full results will be presented (N=~60). Preliminary results show that conclusions drawn from a VNE appear comparable to those from an INPE in diagnosis and localization of neurological complaints. The IPNE may provide a more detailed assessment to detect subtle abnormalities unrelated to the reason for referral. This study’s outcomes will inform the use of virtual care across a variety of neurological presentations.