Eckley Marissa J, Hsu Connie, Tenforde Adam S
Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02115, USA.
Healthcare (Basel). 2023 May 27;11(11):1574. doi: 10.3390/healthcare11111574.
(1) Background: The purpose of this study is to describe whether telehealth compared with in-person visits, led to a similar agreement of primary diagnosis reached at the time of procedure using extracorporeal shockwave therapy. (2) Methods: This retrospective study consisted of chart reviews of all new patients evaluated in a sports medicine clinic prior to performing extracorporeal shockwave therapy from April 2020 to March 2021. The primary outcome of the study was describing agreement in primary diagnosis at the time of evaluation (telehealth and in-person) and during the procedure using extracorporeal shockwave therapy. Logistic regression was utilized to identify patient characteristics that may predict agreement of diagnosis using telehealth. (3) Results: The chart review identified 166 patients (45 telehealth and 121 in-person) evaluated for extracorporeal shockwave therapy. Agreement of diagnosis was similar for patients evaluated using telehealth compared to in-person visits (84% vs. 92%, Χ = 1.90, = 0.168). Agreement on diagnosis was more likely in patients who started shockwave within the 1 week of initial visit (OR = 8.27, 95% CI = 1.69-45.29), patients over age 60 (OR = 0.94, 95% CI = 0.90-0.99), and in patients without a history of osteoarthritis (OR = 14.00, 95% CI = 1.88-113.46). (4) Conclusions: Telehealth resulted in a similar agreement to in-person visits to identify a primary diagnosis for planning extracorporeal shockwave therapy. Telehealth may be a reasonable alternative to in-person visits for procedural planning of extracorporeal shockwave therapy.
(1)背景:本研究的目的是描述与面对面就诊相比,远程医疗在使用体外冲击波疗法进行治疗时,是否能达成相似的初步诊断结果。(2)方法:这项回顾性研究包括对2020年4月至2021年3月在一家运动医学诊所接受体外冲击波治疗前评估的所有新患者的病历审查。该研究的主要结果是描述评估时(远程医疗和面对面)以及使用体外冲击波治疗过程中初步诊断的一致性。采用逻辑回归来确定可能预测使用远程医疗诊断一致性的患者特征。(3)结果:病历审查确定了166例接受体外冲击波治疗评估的患者(45例通过远程医疗,121例面对面)。与面对面就诊的患者相比,通过远程医疗评估的患者诊断一致性相似(84%对92%,Χ = 1.90,P = 0.168)。在初次就诊后1周内开始冲击波治疗的患者(优势比 = 8.27,95%置信区间 = 1.69 - 45.29)、60岁以上的患者(优势比 = 0.94,95%置信区间 = 0.90 - 0.99)以及没有骨关节炎病史的患者(优势比 = 14.00,95%置信区间 = 1.88 - 113.46)中,诊断一致性更高。(4)结论:远程医疗在确定体外冲击波治疗计划的初步诊断方面与面对面就诊达成了相似的一致性。对于体外冲击波治疗的程序规划,远程医疗可能是面对面就诊的合理替代方案。