Telemedicine Physical Examination Utilizing a Consumer Device Demonstrates Poor Concordance with In-Person Physical Examination in Emergency Department Patients with Sore Throat: A Prospective Blinded Study

Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association
Moneeb AkhtarNicholas M Mohr

Abstract

Telemedicine allows patients to connect with healthcare providers remotely. It has recently expanded to evaluate low-acuity illnesses such as pharyngitis by using patients' personal communication devices. The purpose of our study was to compare the telemedicine-facilitated physical examination with an in-person examination in emergency department (ED) patients with sore throat. This was a prospective, observational, blinded diagnostic concordance study of patients being seen for sore throat in a 60,000-visit Midwestern academic ED. A telemedicine and a face-to-face examination were performed independently by two advanced practice providers (APP), blinded to the results of the other evaluator. The primary outcome was agreement on pharyngeal redness between the evaluators, with secondary outcomes of agreement and inter-rater reliability on 14 other aspects of the pharyngeal physical examination. We also conducted a survey of patients and providers to evaluate perceptions and preferences for sore throat evaluation using telemedicine. Sixty-two patients were enrolled, with a median tonsil size of 1.0. Inter-rater agreement (kappa) for tonsil size was 0.394, which was worse than our predetermined concordance threshold. Other kappa v...Continue Reading

References

Jun 2, 2000·BMJ : British Medical Journal·F Mair, P Whitten
Feb 15, 2001·The New England Journal of Medicine·A L Bisno
Jun 26, 2001·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·D G EllisG J Pierluisi
Sep 29, 2001·Journal of Telemedicine and Telecare·R L Bratton
Oct 29, 2005·The Lancet Infectious Diseases·Jonathan R CarapetisMartin Weber
Nov 10, 2005·JAMA : the Journal of the American Medical Association·Jeffrey A LinderJonathan A Finkelstein
Feb 10, 2006·The New England Journal of Medicine·Sandeep Jauhar
Jul 18, 2006·Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association·Kenneth M McConnochieKlaus J Roghmann
Feb 5, 2008·Pediatrics·Elizabeth PfohGrace M Lee
Sep 9, 2008·Journal of Telemedicine and Telecare·Prathibha VarkeyPhilip T Hagen
Aug 17, 2011·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher R CarpenterJesse M Pines
Aug 2, 2013·Pediatric Emergency Care·Itay AyalonShimon Reif
May 27, 2015·JAMA Internal Medicine·Lori Uscher-PinesAteev Mehrotra
Oct 22, 2015·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Lori Uscher-PinesAteev Mehrotra
Oct 30, 2015·BMJ : British Medical Journal·Patrick M BossuytUNKNOWN STARD Group
Jul 10, 2017·International Journal of Pediatric Otorhinolaryngology·Thorbjörn LundbergClaude Laurent

❮ Previous
Next ❯

Citations

Sep 8, 2018·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Sapir NachumRahul Sharma
Nov 7, 2019·Journal of Telemedicine and Telecare·Ali M AnsaryJohn D Scott
Jan 22, 2021·JAMA Otolaryngology-- Head & Neck Surgery·Yi CaiJolie L Chang
Jan 30, 2021·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Salim SaiyedRashmi Singh
Feb 5, 2021·Journal of Telemedicine and Telecare·Nathaniel E MillerJennifer L Pecina
Mar 24, 2021·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Lucas M DonovanGeorge G Sayre
Mar 23, 2021·JB & JS Open Access·Stefanos F HaddadRichard L Uhl
Apr 23, 2021·International Journal of Pediatric Otorhinolaryngology·Caroline M KolbNicole L Aaronson
May 30, 2021·The American Journal of Medicine·Joel Steven WillisKatherine Schreiner
Jul 11, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Emily M HaydenUNKNOWN Society for Academic Emergency Medicine 2020 Consensus Conference
Sep 8, 2021·Frontiers in Pediatrics·Mohamad-Hani TemsahMazin Barry
Sep 21, 2021·Journal of Telemedicine and Telecare·Brian Z ChinFareed Hy Kagda

❮ Previous
Next ❯

Software Mentioned

SAS
Teladoc

Related Concepts

Related Feeds

Alzheimer's Disease: APP

Amyloid precursor protein (APP) proteolysis is critical for the development of Alzheimer's disease, a neurodegenerative disease associated with accumulation of amyloid plaques in the brain. Here is the latest research on APP and Alzheimer's disease.

Birth Defects

Birth defects encompass structural and functional alterations that occur during embryonic or fetal development and are present since birth. The cause may be genetic, environmental or unknown and can result in physical and/or mental impairment. Here is the latest research on birth defects.