Diagnostic Accuracy Comparison Between Telemedicine and Face-to-face Consultations in Respiratory Infection Patients.
- Conditions
- Respiratory Tract Infections
- Interventions
- Other: Telemedicine ConsultationOther: Face-to-face Consultation
- Registration Number
- NCT04806477
- Lead Sponsor
- Hospital Israelita Albert Einstein
- Brief Summary
This is a randomized study that sought to analyze the diagnostic accuracy of the telemedicine consultation of patients suspected of respiratory tract infections during COVID-19 pandemic in comparison with the face-to-face evaluation at the emergency department.
- Detailed Description
Unicentric, prospective and randomized study performed between September and November 2020 with adult patients who sought care at emergency department. The inclusion criterion was the exhibition of any tract respiratory symptom. Patients older than 65 years, with chronic heart or lung diseases or immunosuppressed were excluded. Eligible patients were randomized 1:1 for a brief telemedicine consultation, blinded to subsequent face-to-face evaluation or direct face-to-face evaluation.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 98
- Patients with at least one acute symptom compatible with RTI (sore throat, nasal obstruction, coryza, new or growing cough, sputum, hoarseness, dyspnea) in presence or absence of symptoms related to the infection (fever ≥ 38oC, chills, sweating, myalgia) that motivated spontaneously face-to-face evaluation at the ED.
- Patients with diagnosis of chronic respiratory diseases (chronic obstructive pulmonary disease, asthma and interstitial lung disease)
- Patients with previous diagnosis of congestive heart failure,
- Patients with HIV / AIDS
- Patients with active cancer
- Patients with type I diabetes mellitus
- Patients in use of any immunosuppressant
- Patients with chronic cough
- Patiets that referral to emergency room after nursing triage.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Adult patients with respiratory tract symptom - telemedicine before face-to-face evaluation Telemedicine Consultation We included adults (≥18 years of age) who had at least one acute symptom compatible with Respiratory Tract Infection (sore throat, nasal obstruction, coryza, new or growing cough, sputum, hoarseness, dyspnea) with or without symptoms related to the infection (fever ≥ 38oC, chills, sweating, myalgia) who have undergone telemedicine consultation before face-to-face evaluation Adult patients with respiratory tract symptom - only face-to-face evaluation Face-to-face Consultation We included adults (≥18 years of age) who had at least one acute symptom compatible with Respiratory Tract Infection (sore throat, nasal obstruction, coryza, new or growing cough, sputum, hoarseness, dyspnea) with or without symptoms related to the infection (fever ≥ 38oC, chills, sweating, myalgia) who have undergone only face-to-face evaluation Adult patients with respiratory tract symptom - telemedicine before face-to-face evaluation Face-to-face Consultation We included adults (≥18 years of age) who had at least one acute symptom compatible with Respiratory Tract Infection (sore throat, nasal obstruction, coryza, new or growing cough, sputum, hoarseness, dyspnea) with or without symptoms related to the infection (fever ≥ 38oC, chills, sweating, myalgia) who have undergone telemedicine consultation before face-to-face evaluation
- Primary Outcome Measures
Name Time Method Number of final evaluation ICD 10-code diagnosis. up to 10 months All institutional Emergency Department or Telemedicine assessments involve filling out the final diagnosis on an International Classification of Diseases (ICD-10)-code basis in the electronic medical record before discharge to home or admission. For aggregation of most prevalent RTI with similar pathophysiologic characteristics, three diagnostic groups were defined, based on ICD 10 codes: RTI, including COVID-19 (B34.2, B34.9, B97.2, J00, J04, J06, J11, J20, J30, J39, U07.1); PT - Acute Pharyngotonsillitis (J02-J03.9) and AS - Acute Sinusitis (J01-J01.9).
- Secondary Outcome Measures
Name Time Method Rate of indication for complementary exams up to 10 months Comparison of rate (percentage) of indication for complementary exams between telemedicine and face-to-face consultation.
Time of medical care up to 10 months Comparison of time (minutes) of medical care between telemedicine and face-to-face consultation.
Type of requested exams up to 10 months Comparison of type of requested exams (porcentage) between telemedicine and face-to-face consultation.
Type of Medical prescription up to 10 months Comparison of type of medical prescription after completion of the service between telemedicine and face-to-face consultation
Type of proposed destination after completion of the service up to 10 months Comparison of proposed destination (percentage of discharge or hospitalization) after completion of the service between telemedicine and face-to-face consultation.
Trial Locations
- Locations (1)
Hospital Israelita Abert Einstein
🇧🇷São Paulo, SP, Brazil