School of Health Management, Southern Medical University, Guangzhou, China.
School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
BMJ Open. 2023 May 10;13(5):e071783. doi: 10.1136/bmjopen-2023-071783.
As direct-to-consumer teleconsultation (hereafter referred to as 'teleconsultation') has gained popularity, an increasing number of patients have been leaving online reviews of their teleconsultation experiences. These reviews can help guide patients in identifying doctors for teleconsultation. However, few studies have examined the validity of online reviews in assessing the quality of teleconsultation against a gold standard. Therefore, we aim to use unannounced standardised patients (USPs) to validate online reviews in assessing both the technical and patient-centred quality of teleconsultations. We hypothesise that online review results will be more consistent with the patient-centred quality, rather than the technical quality, as assessed by the USPs.
In this cross-sectional study, USPs representing 11 common primary care conditions will randomly visit 253 physicians via the three largest teleconsultation platforms in China. Each physician will receive a text-based and a voice/video-based USP visit, resulting in a total of 506 USP visits. The USP will complete a quality checklist to assess the proportion of clinical practice guideline-recommended items during teleconsultation. After each visit, the USP will also complete the Patient Perception of Patient-Centeredness Rating. The USP-assessed results will be compared with online review results using the intraclass correlation coefficient (ICC). If ICC >0.4 (p<0.05), we will assume reasonable concordance between the USP-assessed quality and online reviews. Furthermore, we will use correlation analysis, Lin's Coordinated Correlation Coefficient and Kappa as supplementary analyses.
This study has received approval from the Institutional Review Board of Southern Medical University (#Southern Medical Audit (2022) No. 013). Results will be actively disseminated through print and social media, and USP tools will be made available for other researchers.
The study has been registered at the China Clinical Trials Registry (ChiCTR2200062975).
随着直接面向消费者的远程问诊（以下简称“远程问诊”）越来越受欢迎，越来越多的患者开始在网上对他们的远程问诊体验进行评价。这些评价可以帮助患者选择合适的远程问诊医生。然而，很少有研究评估在线评价在评估远程问诊质量方面的有效性是否符合黄金标准。因此，我们旨在使用未事先通知的标准化患者（USPs）来验证在线评价在评估远程问诊的技术和以患者为中心的质量方面的有效性。我们假设在线评价结果与 USPs 评估的以患者为中心的质量更一致，而不是与技术质量更一致。
在这项横断面研究中，USPs 将代表 11 种常见的初级保健疾病，通过中国三大远程问诊平台随机访问 253 名医生。每位医生将接受基于文本和基于语音/视频的 USP 访问，总共进行 506 次 USP 访问。USP 将完成一份质量检查表，以评估远程问诊中临床实践指南推荐项目的比例。每次访问后，USP 还将完成患者对以患者为中心的感知评估。USP 评估结果将与在线评价结果进行比较，使用组内相关系数（ICC）。如果 ICC>0.4（p<0.05），则假设 USP 评估质量与在线评价具有合理的一致性。此外，我们还将使用相关性分析、Lin 协调相关系数和 Kappa 作为补充分析。
这项研究已获得南方医科大学伦理委员会的批准（#南方医科大学审核（2022）No.013）。研究结果将通过印刷和社交媒体积极传播，USP 工具也将提供给其他研究人员。
该研究已在中国临床试验注册中心（ChiCTR2200062975）注册。
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