Concordance between real-time telemedicine assessments and face-to-face consultations in paediatric otolaryngology

Smith, Anthony C., Dowthwaite, Samuel, Agnew, Julie and Wootton, Richard (2008) Concordance between real-time telemedicine assessments and face-to-face consultations in paediatric otolaryngology. Medical Journal of Australia, 188 8: 457-460.


Author Smith, Anthony C.
Dowthwaite, Samuel
Agnew, Julie
Wootton, Richard
Title Concordance between real-time telemedicine assessments and face-to-face consultations in paediatric otolaryngology
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-792X
Publication date 2008-04-21
Year available 2008
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 188
Issue 8
Start page 457
End page 460
Total pages 4
Editor Martin Van Der Weyden
Place of publication Pyrmont, NSW, Australia
Publisher Australasian Medical Publication
Language eng
Subject C1
920203 Diagnostic Methods
920299 Health and Support Services not elsewhere classified
111403 Paediatrics
110323 Surgery
110315 Otorhinolaryngology
Abstract Objective: To determine agreement between diagnoses and management plans made during an initial videoconference appointment and subsequent face-to-face consultations in paediatric ear, nose and throat (ENT) surgery.
Formatted abstract

Objective: To determine agreement between diagnoses and management plans made during an initial videoconference appointment and subsequent face-to-face consultations in paediatric ear, nose and throat (ENT) surgery.

Design and setting and participants: A paediatric ENT clinic servicing patients from Bundaberg, Queensland, was conducted through the Centre for Online Health at the Royal Children’s Hospital (RCH) in Brisbane. Between January 2004 and February 2006, 152 consultations with 97 patients were carried out. We retrospectively audited patients’ charts to compare the diagnosis and management plan formulated at the initial videoconference and the eventual diagnosis and surgical management after face-to-face consultation. The clinical outcomes for children who were not recommended for surgery at the RCH were ascertained by telephone survey.

Main outcome measures: Agreement between videoconference and face-to-face consultation findings.

Results: Of the 97 patients, 75 were recommended for surgical management at the RCH. The remaining patients were either referred back to their general practitioner (9), followed up by the regional paediatrician (10) or lost to follow-up (3). At the conclusion of the study, seven patients were still awaiting surgery and were excluded. Among the 68 patients seen via videoconference and in person, the recorded diagnosis was the same in 99% of cases (67). Surgical management decisions were the same in 93% of cases (63). Telephone follow-up with paediatricians and GPs confirmed that there were no missed diagnoses or ongoing ENT-related problems in the 19 patients referred back to their care.

Conclusions: Decisions about ENT surgical interventions for children assessed during videoconference clinics are in close agreement with decisions made by the same surgeon at face-to-face consultation. The way is open to employ telemedicine more widely for pre-admission ENT assessment. However, as in any telemedicine work, widespread application requires care.

Keyword Telemedicine
Paediatric
Otolaryngology
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
Centre for Online Health Publications
 
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Created: Tue, 24 Mar 2009, 21:06:23 EST by Lisa Garner on behalf of Centre for On-Line Health