Assessment of the Efficacy of Telephone Medicine Consultations in Trauma and Orthopaedics During COVID-19 Using the Ashford Clinic Letter Score

Raad, Marjan; Ndlovu, Sebastian; Neen, Daniel

doi:10.7759/cureus.13871

Cited by 6 publications

(15 citation statements)

References 9 publications

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“…However, across the two studies conducted with different participants through different timeframes there were conflicting results with Sibanda et al (2021) reporting that patients seen via telephone consultations during COVID scored significantly lower than those seen in-person during COVID (IPC: 7.967; TeC: 7.333; p<0.05). Whereas Raad et al (2021) reported that patients seen via telephone consultations during COVID scored significantly higher than those seen in-person pre-COVID (IPC: 6.7; TeC: 7.275; p<0.001).…”

Section: Resultsmentioning

confidence: 94%

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A rapid review of the effectiveness of remote consultations versus face-to-face consultations in secondary care surgical outpatient settings

Edwards

Csontos

Gillen

et al. 2022

Preprint

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The use of remote consultations and telemedicine approaches significantly increased over the pandemic. There is evidence that some patients still prefer this mode of care delivery and time saving may also enable additional consultations and help to reduce waiting lists. However, the effectiveness of remote consulting for certain specialities, such as surgery, is unclear. The aim of this review was to investigate the effectiveness of video or telephone consultations, particularly focusing on clinical, patient reported and safety outcomes, in adult secondary surgical outpatient care during the COVID-19 pandemic. 14 studies were identified. These were published in 2021-2022. Evidence is low or very-low quality due to observational study designs, small sample sizes and patient selection. Policy and practice implications: Evidence is of low quality but suggests that for many surgical outpatient consultations, remote consultations are as effective as in-person consultations. There is potential for time and cost savings for remote consultations compared to in-person consultations. High quality research is needed to evaluate the effectiveness of remote consultations to understand which patients and which surgical specialities would benefit most.

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Section: Resultsmentioning

confidence: 94%

“…Eight studies were conducted in the USA and three in the UK (Natale et al 2022, Raad et al 2021, Sibanda et al 2021). Numbers of participants across the studies ranged from 33 (Lightsey et al 2021) to 535 (Uppal et al 2022).…”

Section: Resultsmentioning

confidence: 99%

A rapid review of the effectiveness of remote consultations versus face-to-face consultations in secondary care surgical outpatient settings

Edwards

Csontos

Gillen

et al. 2022

Preprint

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“…Teleconsultation remains frequent despite less stringent compliance with mask use and social distancing laws [4,59]. The increase in the use of telemedicine included both voice [88][89][90][91], multimedia [66,[92][93][94][95][96], video consultations [34,63,74,97] as well as videoconferences [13,[98][99][100][101][102][103][104][105]. Videoconferences ensure better patient identification and confirmation of the patient's identity without additional difficulties [106,107].…”

Section: Discussionmentioning

confidence: 99%

“…Telephone teleconsultation remains an essential and recognized means of providing remote medical services. Raad et al [90] observed that telephone clinics were practical and superior to traditional clinics for a specific set of patients during the pandemic. Estel et al [110] recommended orthopedic telemedical consultation because of the high acceptance, objective benefits, and similarity of clinical results with F2F visits.…”

Section: Discussionmentioning

confidence: 99%

Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

Glinkowski

2022

IJERPH

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The COVID-19 pandemic has caused a substantial intensification of the telemedicine transformation process in orthopedics since 2020. In the light of the legal regulations introduced in Poland, from the beginning of the SARS-CoV-2 pandemic, physicians, including orthopedic surgeons, have had the opportunity to conduct specialist teleconsultations. Teleconsultations increase epidemiological safety and significantly reduce the exposure of patients and medical staff to direct transmission of the viral vector and the spread of infections. The study aimed to describe diagnoses and clinical aspects of consecutive orthopedic teleconsultations (TC) during the pandemic lockdown. The diagnoses were set according to the International Classification of Diseases (ICD-10). Hybrid teleconsultations used smartphones and obligatory Electronic Health Record (EHR) with supplemental voice, SMS, MMS, Medical images, documents, and video conferencing if necessary. One hundred ninety-eight consecutive orthopedic teleconsultations were served for 615 women and 683 men (mean age 41.82 years ± 11.47 years). The most frequently diagnosed diseases were non-acute orthopedic disorders “M” (65.3%) and injuries “S” (26.3%). Back pain (M54) was the most frequent diagnosis (25.5%). Although virtual orthopedic consultation cannot replace an entire personal visit to a specialist orthopedic surgeon, in many cases, teleconsultation enables medical staff to continue to participate in providing medical services at a sufficiently high medical level to ensure patient and physician. The unified approach to TC diagnoses using ICD-10 or ICD-11 may improve further research on telemedicine-related orthopedics repeatability. Future research directions should address orthopedic teleconsultations’ practical aspects and highlight legal, organizational, and technological issues with their implementations.

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“…We used the Ashford Clinic Letter Scoring System (ACLS) to score clinic letters in an elective shoulder and elbow orthopaedic clinic. The ACLS tool has proven to be reliable, reproducible, and concise, which aids in objectively assessing and auditing the quality and efficacy of consultations [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

How Effective Are Telephone and Video Consultations in Shoulder and Elbow Clinics? Analysis Using an Objective Scoring Tool

Sibanda¹,

Onubogu²,

Raad³

et al. 2021

Cureus

Self Cite

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Introduction: The coronavirus disease 2019 (COVID-19) pandemic resulted in disruptions of clinical services, which saw more clinics being conducted as telephone and videos. The study aimed to assess and compare the effectiveness of consultations, that is, telephone, video, and face-to-face (F2F) in a shoulder and elbow clinic. Methods: A total of 84 clinic letters from a shoulder and elbow clinic at a district general hospital were analysed using the Ashford Clinic Letter Scoring System. Of these, 30 were F2F, 30 were telephone, and 24 were video consultations. The letters were analysed and scored based on four parameters, that is, whether a working diagnosis was formulated, relevant investigations were requested or available, a clear management plan was formulated, and whether the consultation was deemed valuable by both the clinician and patient. Results: The mean score (out of a total possible of eight) for F2F was 7.967, 7.667 for video, and 7.333 for telephone consultations. Amongst new referrals, F2F performed the best, followed by video with telephone consultations scoring the lowest. With follow-up referrals, the performance of telephone and video consultations was similar but more inferior compared to F2F. Videos performed nearly as well as F2F when it came to formulating treatment plans for patients. Conclusion: F2F consultations remain the gold standard in a shoulder and elbow clinic; however, careful stratification of patients into video, telephone, and F2F clinics can help in optimal delivery of care. These findings can be applied to other surgical specialties and medicine in general. Virtual clinics are viable and potentially cost-effective options to the traditional F2F.

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Assessment of the Efficacy of Telephone Medicine Consultations in Trauma and Orthopaedics During COVID-19 Using the Ashford Clinic Letter Score

Cited by 6 publications

References 9 publications

A rapid review of the effectiveness of remote consultations versus face-to-face consultations in secondary care surgical outpatient settings

A rapid review of the effectiveness of remote consultations versus face-to-face consultations in secondary care surgical outpatient settings

Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

How Effective Are Telephone and Video Consultations in Shoulder and Elbow Clinics? Analysis Using an Objective Scoring Tool

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