Please select the eligibility criteria that correspond to the clinical trial below.
Title: Providing Specialty Care to Individuals With Parkinsonism Directly in Their Homes Via Web-based Video Conferencing- A Comparative Effectiveness Study
Brief Summary: The investigators will conduct a two-arm, parallel group, randomized comparative effectiveness study across two sites to increase specialty access and improve care for individuals with Parkinsonism and their caregivers. Twenty individuals with Parkinsonism will be recruited from Johns Hopkins University and the University of Rochester (approximately ten from each site). They will then be randomized to either continue their usual in-person care with a specialist or to receive care with their specialist via telemedicine in their home. Following an in-person baseline/screening visit, approximately ten individuals in the first arm (virtual house calls) will receive three visits with a movement disorder specialist via telemedicine (using web-based video conferencing) in their home. Approximately ten individuals in the second (control) arm will receive three in-person visits at an academic medical center with the same specialists. Approximately two weeks after the completion of each clinical visit, a nurse or coordinator will call the patient to call to address any questions or ensure appropriate understanding of the recommendation (for both telemedicine and control arms). Overall, the study - consistent with a national priority for comparative effectiveness research - will compare the use of telemedicine to manage Parkinsonism to usual care.


Options:
A: Inclusion Criteria:

* The principal eligibility criteria for participants are the following: age greater than 30, clinical diagnosis of idiopathic Parkinsonism, ability to converse in English, ability and willingness to provide informed consent and complete study requirements, and access to a computer with broadband internet.

Exclusion Criteria:

* The main exclusion criterion is a condition (e.g., prominent psychosis) that in the investigator's judgment would preclude participation in a telemedicine visit. Participants may identify a principal caregiver for optional participation in the study.
B: Inclusion Criteria:

Criteria for participation in the study include:

* Being overweight (BMI \> 85th percentile for age and sex, weight for height \>85th percentile, or weight \>120% of ideal for height). In addition, at least half of the study participants will have a BMI \> 95th percentile for age and sex. Study participants will have a maximum body weight of 285 pounds.
* Adolescent subjects must also have at least two of the following risk factors:

  * family history of type 2 diabetes in a first-or second-degree relative,
  * race/ethnicity of American Indian, African-American, Hispanic, Asian/Pacific Islander, or
  * signs of insulin resistance (acanthosis nigricans, hypertension, dyslipidemia, or polycystic ovarian syndrome).
* In addition, adolescent subjects must be able to read and speak English or Spanish, have access to the Internet at home, school, or work, be reachable at a telephone number, be willing to participate in monthly 90-minute group meetings, have plans to stay in the San Diego area for the one-year study period, and have an English or Spanish speaking parent/guardian also willing to participate in the study.
* Parental consent (obtained in parents primary language) and subject assent is also required.
* Participants must have a parent or guardian agree to enroll who is able to speak and read in English or Spanish, has ongoing access and uses the internet, and plans to reside in San Diego for the length of the study.

Exclusion Criteria:

Subjects will be excluded from participation if they have any of the following conditions:

* Diabetes
* Pregnancy
* Cardiovascular problem, musculoskeletal problem or any medical condition that would limit their ability to comply with physical activity or dietary recommendations.
* Patients in foster care will be ineligible due to difficulty in obtaining follow-up measures.
C: Inclusion Criteria:

* Implanted within the last 45 days or being considered for implant with a BIOTRONIK ICD with Home Monitoring (HM)/Intracardiac Electrogram (IEGM)-Online technology, or legally marketed future generation device with HM/IEGM Online.
* Able to utilize the HM system throughout the study
* Ability to give informed consent
* Geographically stable and able to return for regular follow-ups for fifteen (15) months
* At least 18 years old

Exclusion Criteria:

* Patients who do not fulfill all inclusion criteria
* Pacemaker dependent
* Currently enrolled in any other cardiac clinical investigation
D: Inclusion Criteria:

* age 20 - 80 years
* office blood pressure \> 150/95 mmHg or systolic blood pressure \>150 mmHg and diastolic blood pressure \< 90 mmHg

Exclusion Criteria:

* not able to perform home blood pressure measurements
* low compliance
* abuse of alcohol/ medicine
* unwillingness to participate

Answer: A