A retrospective cohort study of telephone versus face-to-face clinics for the management of new otology referrals

Abstract

Purpose To compare outcomes of telephone and face-to-face consultations for new otology referrals and discuss the wider use of telemedicine in otology. Methods Retrospective cohort study including new adult otology referrals to our unit, sampled consecutively between March 2021 and May 2021, seen in either a face-to-face or telephone clinic. Primary outcome measure was the proportion of patients with a definitive management outcome (discharged or added to waiting list for treatment) versus the proportion of patients requiring follow-up for further assessment or review. Results 150 new patients referred for a routine otology consultation (75 telephone, 75 face-to-face) were included. 53/75 patients (71%) undergoing a face-to-face consultation received a definitive outcome following initial review, versus 22/75 (29%) telephone patients ( χ 2 < 0.001, OR 5.8). 52/75 (69%) telephone patients were followed up face-to-face for examination. The mean (SD) number of appointments required to reach a definitive outcome was 1.22 (0.58) and 1.75 (0.73) in the face-to-face and telephone cohorts, respectively ( p < 0.001). Conclusions Telephone clinics in otology have played an important role as part of the COVID19 response. However, they are currently limited by a lack of clinical examination and audiometry. Remote assessment pathways in otology that incorporate asynchronous review of recorded examinations alongside audiometry, either conventional or boothless, may mitigate this problem; however, further research is required.

Effectiveness of telehealth versus in-person care during the COVID-19 pandemic: a systematic review

“…We defined case resolution as a patient's chief complaint being addressed in an initial visit and duplication of service as the need for a follow-up visit (e.g., telehealth followed immediately by an in-person visit). We identified 13 observational studies 12,16,23,31,36,47,61,[69][70][71][72][73][74] and 1 RCT 75 that evaluated case resolution and duplication of services across 5 of the clinical areas (Fig. 3C, Supplementary Table 8 -Bottom Tier, and Supplementary Fig.…”