Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States.
Department of Ophthalmology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA, United States.
J Pediatr Surg. 2023 Sep;58(9):1776-1782. doi: 10.1016/j.jpedsurg.2022.12.027. Epub 2022 Dec 28.
A cross-sectional study was conducted to assess the comparative effectiveness of virtual visits for preoperative evaluation and surgical decision-making in three pediatric surgical subspecialties.
Patients who underwent surgical procedures in the departments of Urology, Ophthalmology, and Plastic and Oral Surgery at a tertiary care pediatric hospital over a one-year period during the COVID-19 pandemic were included. Patients were assigned to one of three clinical pathways based on their preoperative visit(s): only in-person visit(s) (IP), a combination of in-person and virtual visit(s) (IP/VV), and only virtual visit(s) (VV). Demographics, procedure information, and patient experience survey results were collected. We then assessed variations in procedure types and patient experience scores in these three patient groups.
There were 431 patients who completed the modified patient experience survey. The most common procedures were circumcision (17%), excision of lesion (16%), and strabismus repair (11%). Survey results were positive, with 90% of participants rating that they would recommend the service to others. No significant differences were found among groups in their demographics, overall care rating, and duration between preoperative clinic visit and procedure. Post-hoc power analysis indicated 87% power to detect a 10% difference in survey ratings between IP and VV cases, confirming non-inferiority in patient satisfaction for virtual preoperative visits.
This study demonstrated the non-inferiority of preoperative virtual visits in three pediatric surgical subspecialties as measured by patient experience scores. Additional studies with more granular scope are necessary to further elucidate telemedicine's safety and efficacy for select diagnoses.
III.
本横断面研究旨在评估虚拟访视在三个小儿外科亚专科的术前评估和手术决策中的比较效果。
本研究纳入了在 COVID-19 大流行期间于一家三级儿科医院的泌尿科、眼科和整形与口腔外科接受手术的患者。根据术前访视(仅当面访视(IP)、当面访视与虚拟访视相结合(IP/VV)和仅虚拟访视(VV)),将患者分配到三个临床路径之一。收集了患者的人口统计学、手术信息和患者体验调查结果。然后,我们评估了这三组患者的手术类型和患者体验评分的变化。
共有 431 名患者完成了改良的患者体验调查。最常见的手术为包皮环切术(17%)、病灶切除术(16%)和斜视修复术(11%)。调查结果为阳性,90%的参与者表示会向他人推荐该服务。三组患者在人口统计学、整体护理评分和术前就诊与手术之间的时间间隔方面无显著差异。事后功效分析表明,对于 IP 和 VV 病例,在调查评分上有 10%差异的检测能力为 87%,这证实了虚拟术前访视在患者满意度方面的非劣效性。
本研究通过患者体验评分证明了三个小儿外科亚专科中术前虚拟访视的非劣效性。需要进行更多具有更精细范围的研究,以进一步阐明远程医疗在某些诊断中的安全性和有效性。
III 级。