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Accuracy of virtual assessment in hand trauma

A virtual clinic was developed from an existing telemedicine system to manage hand trauma in the Queen Victoria Hospital, East Grinstead, UK, during the first wave of the COVID-19 pandemic. This study evaluates the accuracy of the assessments made and makes comparisons to the traditional face-to-fac...

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Detalles Bibliográficos
Autores principales: Westley, S., Mistry, R., Dheansa, B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8669340/
https://www.ncbi.nlm.nih.gov/pubmed/34917733
http://dx.doi.org/10.1016/j.jpra.2021.10.008
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author Westley, S.
Mistry, R.
Dheansa, B.
author_facet Westley, S.
Mistry, R.
Dheansa, B.
author_sort Westley, S.
collection PubMed
description A virtual clinic was developed from an existing telemedicine system to manage hand trauma in the Queen Victoria Hospital, East Grinstead, UK, during the first wave of the COVID-19 pandemic. This study evaluates the accuracy of the assessments made and makes comparisons to the traditional face-to-face clinic. The accuracy of assessment was analysed by comparing diagnosis with findings at surgery. One hundred and eighty-nine virtual assessments conducted by telephone with photographic data or by video were compared to 129 face-to-face assessments conducted prior to the pandemic. There was no difference in the accuracy of virtual and face-to-face clinics for patients treated surgically (p=0.27); treatment was correctly predicted for 87% of the virtual group and 78% of the face-to-face group. However, fewer virtual assessments led to a surgical outcome (p=0.0064); 68% of the virtual group had surgical outcomes compared to 82% of the face-to-face group. Most face-to-face assessments were done by a specialty trainee compared to a range of clinicians in the virtual clinic. Accuracy of assessment among trainees was significantly associated with experience for the virtual (p=0.045) but not face-to-face clinics (p=0.94). Virtual assessment by video versus telephone plus photographs were similarly accurate. We conclude that virtual triage serves as a successful alternative to face-to-face appointments. It is robust and succeeds in reducing footfall to the hospital site in line with recent social distancing measures against COVID-19. We have shown that video conferencing triage is no better than telemedicine triage with telephone and photographs.
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spelling pubmed-86693402021-12-15 Accuracy of virtual assessment in hand trauma Westley, S. Mistry, R. Dheansa, B. JPRAS Open Original Article A virtual clinic was developed from an existing telemedicine system to manage hand trauma in the Queen Victoria Hospital, East Grinstead, UK, during the first wave of the COVID-19 pandemic. This study evaluates the accuracy of the assessments made and makes comparisons to the traditional face-to-face clinic. The accuracy of assessment was analysed by comparing diagnosis with findings at surgery. One hundred and eighty-nine virtual assessments conducted by telephone with photographic data or by video were compared to 129 face-to-face assessments conducted prior to the pandemic. There was no difference in the accuracy of virtual and face-to-face clinics for patients treated surgically (p=0.27); treatment was correctly predicted for 87% of the virtual group and 78% of the face-to-face group. However, fewer virtual assessments led to a surgical outcome (p=0.0064); 68% of the virtual group had surgical outcomes compared to 82% of the face-to-face group. Most face-to-face assessments were done by a specialty trainee compared to a range of clinicians in the virtual clinic. Accuracy of assessment among trainees was significantly associated with experience for the virtual (p=0.045) but not face-to-face clinics (p=0.94). Virtual assessment by video versus telephone plus photographs were similarly accurate. We conclude that virtual triage serves as a successful alternative to face-to-face appointments. It is robust and succeeds in reducing footfall to the hospital site in line with recent social distancing measures against COVID-19. We have shown that video conferencing triage is no better than telemedicine triage with telephone and photographs. Elsevier 2021-11-07 /pmc/articles/PMC8669340/ /pubmed/34917733 http://dx.doi.org/10.1016/j.jpra.2021.10.008 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Westley, S.
Mistry, R.
Dheansa, B.
Accuracy of virtual assessment in hand trauma
title Accuracy of virtual assessment in hand trauma
title_full Accuracy of virtual assessment in hand trauma
title_fullStr Accuracy of virtual assessment in hand trauma
title_full_unstemmed Accuracy of virtual assessment in hand trauma
title_short Accuracy of virtual assessment in hand trauma
title_sort accuracy of virtual assessment in hand trauma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8669340/
https://www.ncbi.nlm.nih.gov/pubmed/34917733
http://dx.doi.org/10.1016/j.jpra.2021.10.008
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