Efetividade da teleconsulta no primeiro atendimento ortopédico eletivo comparada ao padrão presencial
Objetivo O objetivo do estudo foi comparar se os diagnósticos das doenças ortopédicas realizados por teleconsulta (TC) são os mesmos dos atendimentos presenciais. Método Estudo primário, observacional, prospectivo, analítico, com dados colhidos de maio a junho de 2021, com participantes provenientes...
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          | Published in | Revista brasileira de ortopedia Vol. 58; no. 4; pp. e580 - e585 | 
|---|---|
| Main Authors | , | 
| Format | Journal Article | 
| Language | Portuguese | 
| Published | 
          
        01.08.2023
     | 
| Online Access | Get full text | 
| ISSN | 0102-3616 1982-4378  | 
| DOI | 10.1055/s-0042-1756324 | 
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| Abstract | Objetivo O objetivo do estudo foi comparar se os diagnósticos das doenças ortopédicas realizados por teleconsulta (TC) são os mesmos dos atendimentos presenciais.
Método Estudo primário, observacional, prospectivo, analítico, com dados colhidos de maio a junho de 2021, com participantes provenientes da rede municipal local que foram encaminhados ao ambulatório de ortopedia de referência e oferecida participação no estudo com duas avaliações: a primeira por teleatendimento e a segunda de forma presencial. Cada participante foi atendido por dois diferentes profissionais, e cada um emitiu um diagnóstico. Os profissionais do atendimento presencial não conheciam os diagnósticos prévios. Os diagnósticos emitidos foram comparados para avaliar o grau de semelhança. Ainda, foi aferido o tempo para realização dos atendimentos e o grau de satisfação do profissional participante.
Resultados Foram avaliados 43 pacientes e 07 profissionais participaram, totalizando 44 TC e 43 atendimentos presenciais. O índice de semelhança do diagnóstico foi de 81,4%. A TC teve um tempo menor para realização (média de 4,8 minutos), que o presencial. A satisfação dos profissionais foi menor na TC nos quatro critérios avaliados, sendo, respectivamente, 79,1, 23,3, 46,6 e 37,2.
Conclusão A TC tem concordância no diagnóstico superior a 80% em comparação ao atendimento presencial. Já a realização do teleatendimento teve menor tempo de duração e os profissionais se consideraram menos satisfeitos em relação ao atendimento presencial.
Objective The study aimed to compare whether the diagnoses of orthopedic diseases at telemedicine (TM) consultations are the same as those established at face-to-face visits.
Method Primary, observational, prospective, analytical study, with subjects from the local municipal network who were referred to the orthopedics outpatient clinic from May to June 2021. Subjects underwent two assessments: a telemedicine (TM) consultation and a face-to-face (FF) visit. Two different physicians attended to the patients and established a diagnosis. The physician performing the FF visit was not aware of the previous diagnoses. We compared the diagnoses obtained at both modalities to assess the degree of similarity. In addition, we determined the time required for consultations and the degree of satisfaction of the physicians.
Results We evaluated 43 patients and seven physicians, totaling 44 TM and 43 FF visits. The diagnostic similarity index was 81.4%. TM consultations were shorter (mean time, 4.8 minutes) than FF visits. Physicians were less satisfied with TM in the four criteria evaluated (respective scores of 79.1, 23.3, 46.6, and 37.2).
Conclusion TM consultations have a diagnoses agreement higher than 80% compared with FF visits. On the other hand, TM consultations were faster, and physicians were less satisfied with them in comparison with FF visits. | 
    
|---|---|
| AbstractList | Objetivo O objetivo do estudo foi comparar se os diagnósticos das doenças ortopédicas realizados por teleconsulta (TC) são os mesmos dos atendimentos presenciais.
Método Estudo primário, observacional, prospectivo, analítico, com dados colhidos de maio a junho de 2021, com participantes provenientes da rede municipal local que foram encaminhados ao ambulatório de ortopedia de referência e oferecida participação no estudo com duas avaliações: a primeira por teleatendimento e a segunda de forma presencial. Cada participante foi atendido por dois diferentes profissionais, e cada um emitiu um diagnóstico. Os profissionais do atendimento presencial não conheciam os diagnósticos prévios. Os diagnósticos emitidos foram comparados para avaliar o grau de semelhança. Ainda, foi aferido o tempo para realização dos atendimentos e o grau de satisfação do profissional participante.
Resultados Foram avaliados 43 pacientes e 07 profissionais participaram, totalizando 44 TC e 43 atendimentos presenciais. O índice de semelhança do diagnóstico foi de 81,4%. A TC teve um tempo menor para realização (média de 4,8 minutos), que o presencial. A satisfação dos profissionais foi menor na TC nos quatro critérios avaliados, sendo, respectivamente, 79,1, 23,3, 46,6 e 37,2.
Conclusão A TC tem concordância no diagnóstico superior a 80% em comparação ao atendimento presencial. Já a realização do teleatendimento teve menor tempo de duração e os profissionais se consideraram menos satisfeitos em relação ao atendimento presencial.
Objective The study aimed to compare whether the diagnoses of orthopedic diseases at telemedicine (TM) consultations are the same as those established at face-to-face visits.
Method Primary, observational, prospective, analytical study, with subjects from the local municipal network who were referred to the orthopedics outpatient clinic from May to June 2021. Subjects underwent two assessments: a telemedicine (TM) consultation and a face-to-face (FF) visit. Two different physicians attended to the patients and established a diagnosis. The physician performing the FF visit was not aware of the previous diagnoses. We compared the diagnoses obtained at both modalities to assess the degree of similarity. In addition, we determined the time required for consultations and the degree of satisfaction of the physicians.
Results We evaluated 43 patients and seven physicians, totaling 44 TM and 43 FF visits. The diagnostic similarity index was 81.4%. TM consultations were shorter (mean time, 4.8 minutes) than FF visits. Physicians were less satisfied with TM in the four criteria evaluated (respective scores of 79.1, 23.3, 46.6, and 37.2).
Conclusion TM consultations have a diagnoses agreement higher than 80% compared with FF visits. On the other hand, TM consultations were faster, and physicians were less satisfied with them in comparison with FF visits. | 
    
| Author | Júnior, Adriano Fernando Mendes Júnior, Jair Moreira Dias  | 
    
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| Cites_doi | 10.1186/s12913-016-1717-7 10.1177/1357633X20938241 10.1089/153056203322502632 10.2106/JBJS.20.00452 10.1258/1357633991932342 10.1007/s11882-018-0814-6 10.2196/11330 10.1177/1357633X18783921 10.1377/hlthaff.2018.05098 10.1016/j.msksp.2018.09.014  | 
    
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| References_xml | – volume: 16 start-page: 483 issue: 01 year: 2016 ident: ref5 article-title: Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial publication-title: BMC Health Serv Res doi: 10.1186/s12913-016-1717-7 – volume: 28 start-page: 291 issue: 06 year: 2022 ident: ref7 article-title: Telemedicine in orthopaedics and its potential applications during COVID-19 and beyond: A systematic review publication-title: J Telemed Telecare doi: 10.1177/1357633X20938241 – volume: 9 start-page: 247 issue: 03 year: 2003 ident: ref1 article-title: Mobile e-health: the unwired evolution of telemedicine publication-title: Telemed J E Health doi: 10.1089/153056203322502632 – volume: 102 start-page: 1109 issue: 13 year: 2020 ident: ref3 article-title: Telemedicine in orthopaedic surgery: challenges and opportunities publication-title: J Bone Joint Surg Am doi: 10.2106/JBJS.20.00452 – volume: 5 start-page: 18 issue: 01 year: 1999 ident: ref11 article-title: Telemedicine in the emergency department: a randomized controlled trial publication-title: J Telemed Telecare doi: 10.1258/1357633991932342 – volume: 18 start-page: 60 issue: 11 year: 2018 ident: ref2 article-title: Telemedicine technology: a review of services, equipment, and other aspects publication-title: Curr Allergy Asthma Rep doi: 10.1007/s11882-018-0814-6 – volume: 21 start-page: e11330 issue: 02 year: 2019 ident: ref8 article-title: Cost- Effectiveness of telemedicine in remote orthopedic consultations: randomized controlled trial publication-title: J Med Internet Res doi: 10.2196/11330 – volume: 25 start-page: 451 issue: 08 year: 2019 ident: ref6 article-title: Patient reported outcomes with remote orthopaedic consultations by telemedicine: A randomised controlled trial publication-title: J Telemed Telecare doi: 10.1177/1357633X18783921 – volume: 37 start-page: 2069 issue: 12 year: 2018 ident: ref10 article-title: Retail outlets using telehealth pose significant policy questions for health care publication-title: Health Aff (Millwood) doi: 10.1377/hlthaff.2018.05098 – volume: 38 start-page: 99 year: 2018 ident: ref9 article-title: Agreement between telehealth and in-person assessment of patients with chronic musculoskeletal conditions presenting to an advanced-practice physiotherapy screening clinic publication-title: Musculoskelet Sci Pract doi: 10.1016/j.msksp.2018.09.014  | 
    
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