Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trial
ABSTRACT Objective To analyze telemedicine diagnostic accuracy in patients with respiratory infections during COVID-19 pandemic compared to face-to-face evaluation in the emergency department. Methods Randomized, unicentric study between September 2020 and November 2020 in patients with any resp...
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| Format: | Article |
| Language: | English |
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Instituto Israelita de Ensino e Pesquisa Albert Einstein
2022-05-01
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| Series: | Einstein (São Paulo) |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082022000100253&tlng=en |
| _version_ | 1818239729935581184 |
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| author | Tarso Augusto Duenhas Accorsi Flavio Tocci Moreira Carlos Henrique Sartorato Pedrotti Karine De Amicis Renata Farias Vidigal Correia Renata Albaladejo Morbeck Fernanda Ferreira Medeiros José Leão de Souza Jr Eduardo Cordioli |
| author_facet | Tarso Augusto Duenhas Accorsi Flavio Tocci Moreira Carlos Henrique Sartorato Pedrotti Karine De Amicis Renata Farias Vidigal Correia Renata Albaladejo Morbeck Fernanda Ferreira Medeiros José Leão de Souza Jr Eduardo Cordioli |
| author_sort | Tarso Augusto Duenhas Accorsi |
| collection | DOAJ |
| description | ABSTRACT Objective To analyze telemedicine diagnostic accuracy in patients with respiratory infections during COVID-19 pandemic compared to face-to-face evaluation in the emergency department. Methods Randomized, unicentric study between September 2020 and November 2020 in patients with any respiratory symptom (exclusion criteria: age >65 years, chronic heart or lung diseases, immunosuppressed). Patients were randomized 1:1 for brief telemedicine followed by face-to-face consultation or direct face-to-face evaluation. The primary endpoint was the International Classification of Diseases code. The secondary analysis comprised length of stay, diagnostic test ordering, medical prescription, and proposed destination. Results Ninety-eight patients were enrolled. The mean age was 36.3±9.7 years old, 57.1% were women, and 81.6% had diagnostic test ordered. Mean grouped by International Classification of Diseases code for upper respiratory tract infection, pharyngotonsillitis, and sinusitis showed no difference between study groups or secondary endpoints. The Telemedicine Group was representative of the population usually evaluated in this center. In the Telemedicine Group (n=48), 18.7% patients would be referred for evaluation at the emergency department. The distribution of diagnoses by telemedicine was 67.4% for upper respiratory tract infection, 2.3% for pharyngotonsillitis, and 0% for sinusitis, being statistically similar to the subsequent face-to-face assessment, respectively: 72.1%, 11.6% and 7% (Kappa 0.386 [95%CI: 0.112-0.66]; p=0.536). Telemedicine ordered COVID-19 molecular (RT-PCR) tests in 76.5% versus 79.4% in face-to-face evaluation (Kappa 0.715 [95%CI: 0.413-1]; p>0.999). Conclusion Diagnostic telemedicine consultation of low-risk patients with acute respiratory symptoms is not inferior to face-to-face evaluation at emergency department. Telemedicine is to be reinforced in the health care system as a strategy for the initial assessment of acute patients. ClinicalTrials.gov Identifier: NCT04806477 |
| first_indexed | 2024-12-12T13:02:11Z |
| format | Article |
| id | doaj.art-a187fb692e684d349d55fb1c5575909f |
| institution | Directory Open Access Journal |
| issn | 2317-6385 |
| language | English |
| last_indexed | 2024-12-12T13:02:11Z |
| publishDate | 2022-05-01 |
| publisher | Instituto Israelita de Ensino e Pesquisa Albert Einstein |
| record_format | Article |
| series | Einstein (São Paulo) |
| spelling | doaj.art-a187fb692e684d349d55fb1c5575909f2022-12-22T00:23:46ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)2317-63852022-05-012010.31744/einstein_journal/2022ao6800Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trialTarso Augusto Duenhas Accorsihttps://orcid.org/0000-0002-8023-3466Flavio Tocci Moreirahttps://orcid.org/0000-0001-6574-3866Carlos Henrique Sartorato Pedrottihttps://orcid.org/0000-0002-0634-7086Karine De Amicishttps://orcid.org/0000-0002-9936-2436Renata Farias Vidigal Correiahttps://orcid.org/0000-0003-2537-0537Renata Albaladejo Morbeckhttps://orcid.org/0000-0003-1789-1738Fernanda Ferreira Medeiroshttps://orcid.org/0000-0002-7069-2597José Leão de Souza Jrhttps://orcid.org/0000-0001-6017-7682Eduardo Cordiolihttps://orcid.org/0000-0001-5405-9380ABSTRACT Objective To analyze telemedicine diagnostic accuracy in patients with respiratory infections during COVID-19 pandemic compared to face-to-face evaluation in the emergency department. Methods Randomized, unicentric study between September 2020 and November 2020 in patients with any respiratory symptom (exclusion criteria: age >65 years, chronic heart or lung diseases, immunosuppressed). Patients were randomized 1:1 for brief telemedicine followed by face-to-face consultation or direct face-to-face evaluation. The primary endpoint was the International Classification of Diseases code. The secondary analysis comprised length of stay, diagnostic test ordering, medical prescription, and proposed destination. Results Ninety-eight patients were enrolled. The mean age was 36.3±9.7 years old, 57.1% were women, and 81.6% had diagnostic test ordered. Mean grouped by International Classification of Diseases code for upper respiratory tract infection, pharyngotonsillitis, and sinusitis showed no difference between study groups or secondary endpoints. The Telemedicine Group was representative of the population usually evaluated in this center. In the Telemedicine Group (n=48), 18.7% patients would be referred for evaluation at the emergency department. The distribution of diagnoses by telemedicine was 67.4% for upper respiratory tract infection, 2.3% for pharyngotonsillitis, and 0% for sinusitis, being statistically similar to the subsequent face-to-face assessment, respectively: 72.1%, 11.6% and 7% (Kappa 0.386 [95%CI: 0.112-0.66]; p=0.536). Telemedicine ordered COVID-19 molecular (RT-PCR) tests in 76.5% versus 79.4% in face-to-face evaluation (Kappa 0.715 [95%CI: 0.413-1]; p>0.999). Conclusion Diagnostic telemedicine consultation of low-risk patients with acute respiratory symptoms is not inferior to face-to-face evaluation at emergency department. Telemedicine is to be reinforced in the health care system as a strategy for the initial assessment of acute patients. ClinicalTrials.gov Identifier: NCT04806477http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082022000100253&tlng=enTelemedicineRespiratory tract infectionsEmergency medical servicesReferral and consultationCOVID-19Coronavirus infections |
| spellingShingle | Tarso Augusto Duenhas Accorsi Flavio Tocci Moreira Carlos Henrique Sartorato Pedrotti Karine De Amicis Renata Farias Vidigal Correia Renata Albaladejo Morbeck Fernanda Ferreira Medeiros José Leão de Souza Jr Eduardo Cordioli Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trial Einstein (São Paulo) Telemedicine Respiratory tract infections Emergency medical services Referral and consultation COVID-19 Coronavirus infections |
| title | Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trial |
| title_full | Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trial |
| title_fullStr | Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trial |
| title_full_unstemmed | Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trial |
| title_short | Telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face-to-face consultation: a randomized trial |
| title_sort | telemedicine diagnosis of acute respiratory tract infection patients is not inferior to face to face consultation a randomized trial |
| topic | Telemedicine Respiratory tract infections Emergency medical services Referral and consultation COVID-19 Coronavirus infections |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082022000100253&tlng=en |
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