Ear, Nose and Throat Department, Royal Sussex County Hospital, Brighton, UK.
Brighton & Sussex Medical School, Falmer, Brighton, UK.
Clin Otolaryngol. 2021 Jul;46(4):699-719. doi: 10.1111/coa.13768. Epub 2021 Mar 29.
Remote or tele-consultation has become an emerging modality of consultation in many specialities, including ENT. Advantages include increasing accessibility, potential to reduce costs and, during the COVID-19 pandemic, reduced risk of infection transmission. Here, we systematically collate and synthesise the evidence base on outcomes from remote consultation in adult and paediatric ENT services.
We performed a review in accordance with PRISMA guidelines. We searched Medline and Embase for relevant articles. Outcomes include specific patient pathway efficiency measures (including number of healthcare visits, lead time, touch time and handoff), patient/clinician satisfaction, cost analysis and safety implications.
From 6325 articles screened, 53 met inclusion criteria. Publications included studies on remote consultation for initial, preoperative and follow-up assessment (including postoperative). In most instances, remote consultation reduced costs and time from referral to assessment and was associated with high patient satisfaction. However, a face-to-face follow-up appointment was required in 13%-72% of initial consultations, suggesting that remote consultation is only appropriate in selected cases.
Remote consultation is appropriate and preferable for ENT consultation in specific conditions and circumstances. Future research should look to better define those conditions and circumstances, and report using recognised quality standards and outcome measures.
远程或远程咨询已成为许多专业（包括耳鼻喉科）咨询的一种新兴模式。其优势包括提高可及性、降低成本的潜力，以及在 COVID-19 大流行期间降低感染传播的风险。在这里，我们系统地整理和综合了有关远程咨询在成人和儿科耳鼻喉科服务中结果的证据基础。
我们按照 PRISMA 指南进行了综述。我们在 Medline 和 Embase 上搜索了相关文章。结果包括特定的患者路径效率指标（包括就诊次数、前置时间、接触时间和交接）、患者/临床医生满意度、成本分析和安全影响。
从筛选出的 6325 篇文章中，有 53 篇符合纳入标准。这些出版物包括关于初始、术前和随访评估（包括术后）的远程咨询研究。在大多数情况下，远程咨询减少了从转诊到评估的成本和时间，并且与患者的高度满意度相关。然而，在 13%-72%的初始咨询中需要进行面对面的随访预约，这表明远程咨询仅适用于特定情况。
远程咨询在特定条件和情况下适用于耳鼻喉科咨询。未来的研究应该更好地定义这些条件和情况，并使用公认的质量标准和结果衡量标准进行报告。
