Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PA, USA.
J Neurooncol. 2022 Sep;159(3):621-626. doi: 10.1007/s11060-022-04102-8. Epub 2022 Jul 28.
To determine if there was a discrepancy between telemedicine versus in-person New Patient Visits (NPVs) regarding the conversion rate to operative and radiosurgery cases at a tertiary surgical neuro-oncology practice.
A retrospective analysis was performed of patients who had an outpatient encounter with a neurosurgeon from the Tumor Division at our institution's Department of Neurosurgery between February 1, 2021 and April 30, 2021. NPVs during this period were registered as either telemedicine or in-person appointments. The primary endpoint of the study was to compare the rate at which telemedicine NPVs and in-person NPVs underwent surgery or radiosurgery, reported as the surgical conversion rate.
A total of 206 patients were included in this study. Of them, 119 (57.8%) were seen using telemedicine and 87 (42.2%) were seen in clinic via an in-person visit. A total of 70 (34%) of all patients underwent surgery or radiosurgery. Of the 119 patients seen via telemedicine, 40 (33.6%) underwent surgery or radiosurgery; during the same period, 87 NPVs were conducted in person and 30 (34.5%, p = 1.0) received an intervention. Further stratification revealed no differences between the two groups across measured criteria including diagnosis, number of pre-operative visits, elapsed time from appointment to surgery, follow-up visits, and distance from home address to neurosurgical clinic.
Telemedicine NPVs did not differ significantly from in-person NPVs when evaluating the likelihood of a new patient committing to surgical treatment. This study provides quantifiable evidence that telemedicine is an effective means of meeting new patients and planning complex neurosurgical interventions.
在一家三级神经外科手术神经肿瘤学实践中，确定远程医疗与新患者门诊就诊（NPV）在手术和放射手术转化率方面是否存在差异。
对 2021 年 2 月 1 日至 2021 年 4 月 30 日期间在我们机构神经外科肿瘤科与神经外科医生进行门诊就诊的患者进行了回顾性分析。在此期间，NPV 被登记为远程医疗或亲自就诊。该研究的主要终点是比较远程医疗 NPV 和亲自 NPV 进行手术或放射手术的比率，报告为手术转化率。
共有 206 例患者纳入本研究。其中，119 例（57.8%）通过远程医疗就诊，87 例（42.2%）通过门诊就诊。共有 70 例（34%）患者接受了手术或放射手术。在通过远程医疗就诊的 119 例患者中，有 40 例（33.6%）接受了手术或放射手术；同期进行了 87 例门诊 NPV，其中 30 例（34.5%，p=1.0）接受了干预。进一步分层显示，两组之间在测量标准上没有差异，包括诊断、术前就诊次数、从预约到手术的时间间隔、随访就诊次数以及从家庭住址到神经外科诊所的距离。
在评估新患者接受手术治疗的可能性时，远程医疗 NPV 与亲自 NPV 没有显著差异。本研究提供了定量证据，证明远程医疗是一种有效的新患者就诊和规划复杂神经外科干预的手段。
