Diagnostic accuracy and management concordance of otorhinolaryngological diseases through telehealth or remote visits: A systematic review & meta-analysis.
| Autor: | Shah SR; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA., Munhall CC; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA., Nguyen SA; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA., O'Rourke AK; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA., Miccichi K; Department of IT Telemedicine, McLeod Health, Florence, SC, USA., Meyer TA; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of telemedicine and telecare [J Telemed Telecare] 2024 Oct; Vol. 30 (9), pp. 1386-1397. Date of Electronic Publication: 2023 Mar 14. |
| DOI: | 10.1177/1357633X231156207 |
| Abstrakt: | Introduction: COVID-19 has led to delays in providing healthcare in both emergency and non-emergency settings, especially in surgical subspecialties which rely heavily on referrals and in-person visits. Without an established telehealth infrastructure, many otorhinolaryngological departments experienced decreases in consultations. Telemedicine has attempted to bridge the gap between pre- and post-pandemic periods by creating a safe avenue of communication between otorhinolaryngologists and patients. This review hopes to address the accuracy of telemedicine in patient diagnosis and management. Methods: Searches were conducted since study conception until June 30, 2022, on multiple databases including PubMed, SCOPUS, and CINAHL for this systematic review and meta-analysis. Diagnostic accuracy, management accuracy, kappa, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were meta-analyzed by comparing virtual visits to in-person visits (gold standard). Results: Nineteen studies were included in this review. A total of 1518 patients were included across all studies. When comparing virtual visits against in-person visits, accurate diagnosis was made in 86.2% [82.1,89.9, I 2 = 73.5%, P < 0.0001] of patients and management accuracy was 91.5% [86.1,95.7, I 2 = 81.8%, P < 0.0001] when treating patients. Kappa value determining interrater reliability was 0.8 [0.7,0.9, I 2 = 81.8%, P < 0.0001]. Conclusion: Our data suggest that diagnostic and management concordance is above 80% when comparing diagnosis and management strategies in patients who underwent both telehealth and in-person visits with an otorhinolaryngologist. In uncomplicated patients, telehealth might be a reliable source for diagnosis and management however, in-person consultation is likely still required for pathologies in which physical exam, imaging or procedural elements represent a vital component of the work-up. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Databáze: | MEDLINE |
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