Developing a synchronous otolaryngology telemedicine Clinic: Prospective study to assess fidelity and diagnostic concordance

Abstract

2c. Laryngoscope, 128:1068-1074, 2018.

Smartphone telemedical emergency department consults for screening of nonacute dizziness

“…Using VNG for remote screening has previously been proposed by Newman‐Toker et al, who have suggested using recorded oculomotor exams in the emergency department for the diagnosis of stroke and acute dizziness using video head impulse testing goggles . Furthermore, synchronous otolaryngology telemedical visits have previously been shown to be effective as well as cost‐effective, including in the field of neuro‐otology . Still, most prior studies on tele‐otolaryngology describe using specialized and costly equipment, which limits the practicality of widespread adoption in today's cost‐conscious environment.…”

“…Still, BPPV is often diagnosed via oculography; thus, we believe 30 patients prove feasibility. In similar studies, Newman‐Toker et al utilized a sample size of 12 patients, Yulzari et al utilized 48 patients to assess teleotolaryngology consults, and Seim et al utilized 21 patients to evaluate synchronous visits . Additionally, the nature of the nystagmus elicited by BPPV is that the response fatigues with repetition.…”

“…6 Furthermore, synchronous otolaryngology telemedical visits have previously been shown to be effective as well as cost-effective, including in the field of neuro-otology. 4,[7][8][9] Still, most prior studies on tele-otolaryngology describe using specialized and costly equipment, which limits the practicality of widespread adoption in today's costconscious environment. Because smart phones with highdefinition video cameras are now ubiquitous, as well as HIPAA-compliant messaging services, we believe telemedical consults are now feasible without any equipment-related barrier to adoption.…”

“…In similar studies, Newman-Toker et al utilized a sample size of 12 patients, 6 Yulzari et al utilized 48 patients to assess teleotolaryngology consults, 9 and Seim et al utilized 21 patients to evaluate synchronous visits. 7 Additionally, the nature of the nystagmus elicited by BPPV is that the response fatigues with repetition. To ensure patient's received the gold standard of care, we initially tested them using the gold standard of VNG testing with a DHT prior to reperforming and recording it with a smartphone.…”

COVID-19 and rhinology: A look at the future

“…Although these are relatively recent studies, we would argue that in our current circumstances, rhinologic patients are amenable to consultation on a remote basis as well. Additionally, there are already available telemedicine platforms used in Otolaryngology that demonstrate its potential benefits in evaluating patients in remote and underserved areas [6], such as Quintree (Quintree Medical LLC, Detroit, Michigan, USA).…”