新冠疫情期间家庭医学中的远程问诊：一个足够的工具？
Teleconsultation in family medicine amid the Covid-19 pandemic: An adequate tool?
机构信息
Infectiologie, centre hospitalier universitaire de Guadeloupe, Pointe-à-Pitre, France.
Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, Pointe-à-Pitre, France.
出版信息
Infect Dis Now. 2022 Jun;52(4):230-232. doi: 10.1016/j.idnow.2022.05.004. Epub 2022 May 7.
INTRODUCTION
Teleconsultation is an emerging tool whose utilization dramatically increased during the Covid-19 pandemic. Our aim was to determine its clinical accuracy.
METHODS
This prospective study was carried out during the first wave of Covid-19. Patients were teleconsulted by either general practitioners or emergency doctors reporting clinical exam results to the ID physicians by phone. Five signs were specifically checked: dyspnea, fever, cough, anosmia and flu-like illness. Data collected by remote consultation were compared to face-to-face examination in an ID Department.
RESULTS
From March to April 2020, 149 patients were seen by remote medical care. Dyspnea was found in 14.1% of the teleconsultation patients vs 3.4% in face-to-face consultation; fever in 47.0 vs. 15.4%; cough in 69.1 vs. 16.1%; anosmia in 3.4 vs. 1.3%; flu-like illness in 53.0 vs. 7.4% (all differences significant: P<0.001).
CONCLUSION
We observed incongruency between remote and face-to-face consultation for the main clinical signs of Covid-19.
简介
远程问诊是一种新兴的工具，在新冠疫情期间其使用率显著提高。我们的目的是确定其临床准确性。
方法
本前瞻性研究于新冠疫情的第一波期间进行。由全科医生或急诊医生对患者进行远程问诊，通过电话向传染病医生报告临床检查结果。专门检查了五种症状：呼吸困难、发热、咳嗽、嗅觉丧失和流感样疾病。通过远程咨询收集的数据与传染病科的面对面检查进行了比较。
结果
2020 年 3 月至 4 月期间，有 149 名患者接受了远程医疗。远程问诊患者的呼吸困难发生率为 14.1%，面对面问诊患者为 3.4%；发热发生率为 47.0%，面对面问诊患者为 15.4%；咳嗽发生率为 69.1%，面对面问诊患者为 16.1%；嗅觉丧失发生率为 3.4%，面对面问诊患者为 1.3%；流感样疾病发生率为 53.0%，面对面问诊患者为 7.4%（所有差异均有统计学意义：P<0.001）。
结论
我们观察到远程问诊和面对面问诊在新冠病毒的主要临床症状方面存在不一致性。
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