Surgical plans generated from telemedicine visits are rarely changed after in-person evaluation in spine patients

Lightsey, Harry M.; Crawford, Alexander M; Xiong, Grace; Schoenfeld, Andrew J.; Simpson, Andrew K.

doi:10.1016/j.spinee.2020.11.009

Cited by 39 publications

(52 citation statements)

References 19 publications

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“…A final study added that 94% of surgical plans established in virtual visits did not change after in-person evaluation of adults with spinal pathology. 29 …”

Section: Back and Lumbosacral Spinementioning

confidence: 99%

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The Telemedicine-Based Pediatric Examination of the Back and Lower Limbs: A Narrative Review

Noutsios

Boisvert-Plante

Laberge

et al. 2021

JPR

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The COVID-19 pandemic has accelerated the transition to virtual healthcare while also prompting an abundance of new literature highlighting telemedicine’s capabilities and limitations for various medical applications, notably musculoskeletal examinations. Telemedicine provides an opportunity to deliver timely patient- and family-centred care while maintaining physical distancing and improving access to remote communities. This review aims to narrate the current state of the literature on telemedicine applied in the context of a musculoskeletal examination for children aged 3 to 18 years. The PubMed and ScienceDirect databases were searched for relevant articles from January 2015 to August 2021 using a combination of keywords and nested searches. The general examination components relevant to the back and lumbosacral spine, hip, knee, ankle/foot, and gait are described. These components include inspection, palpation, range of motion, motor, and sensory examination as well as special testing. There is general feasibility, validity, and substantial reliability in performing most examination components, and primary diagnoses established virtually were found to be either the same or similar in the vast majority of cases. Despite the current literature focusing mainly on adult populations, we describe how each aspect of the exam can be reliably incorporated into a virtual appointment specific to the pediatric population. Currently available smartphone-based applications that measure joint range of motion were generally found to have high reliability and validity. Caregivers are needed for most of the consultation, especially in younger children, but select physical exam maneuvers can be self-performed by older children and adolescents alone. By providing an overview of the available smartphone tools as well as the reliability and validity of remote assessments, this review not only establishes a foundation for a structured pediatric musculoskeletal examination, but also aims to increase providers’ confidence in incorporating telemedicine into their practice.

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“…A final study added that 94% of surgical plans established in virtual visits did not change after in-person evaluation of adults with spinal pathology. 29 …”

Section: Back and Lumbosacral Spinementioning

confidence: 99%

“… 25 , 27 Second, the clinical management decisions made by physicians, including surgical plans, strongly agree with decisions made based on in-person encounters. 28 , 29 …”

Section: Back and Lumbosacral Spinementioning

confidence: 99%

The Telemedicine-Based Pediatric Examination of the Back and Lower Limbs: A Narrative Review

Noutsios

Boisvert-Plante

Laberge

et al. 2021

JPR

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“…4 Other contemporary studies have also been limited to single institutions or specific diagnoses and operations. [10][11][12] The objective of this study is to assess the patterns of telehealth use across surgical specialties before and during the COVID-19 pandemic with the hypothesis that there will be significant variation by surgical specialty.…”

mentioning

confidence: 99%

Use of Telehealth by Surgical Specialties During the COVID-19 Pandemic

et al. 2021

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“…Further investigation should be done to process map the diagnosis of rectal cancer in Alberta, similar to process mapping performed for other general surgical conditions [ 19 , 20 , 21 ]. In a post-COVID19 world, it is critical to identify key patient presentations that should mandate an in-person consultation (versus telehealth) and performance of physical examination maneuvers such as a DRE [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

The Digital Divide: A Retrospective Survey of Digital Rectal Examinations during the Workup of Rectal Cancers

Farooq

Ghosh

et al. 2021

Healthcare

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Background: Digital rectal examination (DRE) is considered an important part of the physical examination. However, it is unclear how many patients have a DRE performed at the primary care level in the work-up of rectal cancer, and if the absence of a DRE causes a delay to consultation with a specialist. Methods: A retrospective patient questionnaire was sent to 1000 consecutive patients with stage II or stage III rectal cancer. The questionnaire asked patients to recall if they had a DRE performed by their general practitioner (GP) when they first presented with symptoms or a positive FIT test. Demographic data, staging data, and time to consultation with a specialist were also collected. Results: A thousand surveys were mailed out, and a total of 262 patients responded. Of the respondents, 46.2% did not recall undergoing a digital rectal examination by their primary care provider. Women were less likely to undergo a DRE than men (28.6% vs. 44.3%, p = 0.019). While there was a trend towards longer times to specialist consultation in patients who did not undergo a DRE (27.0 vs. 12.2 weeks), this was not statistically significant (p = 0.121). Conclusion: A significant proportion of patients who are FIT positive or have symptomatic rectal bleeding do not recall having a DRE by their primary care provider. Barriers may include lack of comfort with performing DRE or lack of time. Clearer guidelines and more support for GP’s may increase uptake of DRE.

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Surgical plans generated from telemedicine visits are rarely changed after in-person evaluation in spine patients

Cited by 39 publications

References 19 publications

The Telemedicine-Based Pediatric Examination of the Back and Lower Limbs: A Narrative Review

The Telemedicine-Based Pediatric Examination of the Back and Lower Limbs: A Narrative Review

Use of Telehealth by Surgical Specialties During the COVID-19 Pandemic

The Digital Divide: A Retrospective Survey of Digital Rectal Examinations during the Workup of Rectal Cancers

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