Similar Accuracy of Surgical Plans After Initial In-Person and Telemedicine Evaluation of Spine Patients

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

“…In two studies, reasons for decision against telemedicine was mentioned, which excluded patients who were complex, high-risk, or needed emergency surgery (Lightsey et al 2021, Greven et al 2022). For five of the included studies, no details on eligibility for telemedicine was reported (Crawford et al 2021, Natale et al 2022, Raad et al 2021, Sibanda et al 2021, Ye et al 2022).…”

“…Change was defined as a change in the extent of surgery offered, in the approach, in type of surgery or region of surgery (Lightsey et al 2021, Ye et al 2022) and whether the patient previously indicated for surgery was found not to merit a surgical procedure (Lightsey et al 2021). Lightsey et al (2021) found that for 94% of cases the surgical plan did not change after subsequent in-person evaluation (95% CI 1% - 20%) and Ye et al (2022) reported that telemedicine (79.5%) and in-person (82.6%) evaluations generated similarly accurate surgical plans that did not need to change on the day of surgery (p>0.05). However, in Ye et al’s study (2022) the telemedicine cohort experienced significantly longer time between the initial appointment and surgery (TMC: 44 days; IPC: 33 days; p<0.05) compared with the in-person cohort.…”

“…Three studies conducted the consultation via both video conferencing and telephone calls (Uppal et al 2022, Henry et al 2022, Sibanda et al 2021), two studies via video conferencing (Choi et al 2022, Aldawoodi et al 2021) and two studies via telephone calls (Natale et al 2022, Raad et al 2021). In four studies no detail was provided regarding how telemedicine was conducted or what platform was used (Crawford et al 2021, Lightsey et al 2021, Greven et al 2022, Ye et al 2022).…”

“…The outcomes varied across the included studies with change in surgical plan being explored across three studies (Crawford et al 2021, Lightsey et al 2021, Ye et al 2022). Time to surgery operation (Natale et al 2021; Ye et al, 2022), day of surgery cancellations (Aldawoodi et al 2021, Natale et al 2022), consultation effectiveness (Raad et al 2021, Sibanda et al 2021), reoperations (Greven et al 2022, Henry et al 2022) were all reported across two studies. A number of other outcomes were explored which included conversions to in-person consultation (Henry et al 2022), readmissions (Natale et al 2022, Greven et al 2022), and costs (Natale et al 2022), mortality (Natale et al 2022), postoperative complications (Henry et al 2022), number of postoperative visits (Henry et al 2022), changes to the postoperative treatment course (Henry et al 2022) and diagnostic concordance between in-person and telemedicine visit (Choi et al 2022).…”

“…Pre-operative consultations have the potential to reduce the length of time a patient is waiting for surgery. Time to surgery was investigated across two studies in this rapid review (Natale et al, 2022; Ye et al 2022) and presented mixed findings but this was due to the inclusion of a historical control group (pre-COVID) in one of the studies (Ye et al 2022) so similar comparisons could not be made. Further studies with concurrent cohorts are needed to investigate this outcome further.…”