Shoulder assessment by smartphone: a valid alternative for times of social distancing

Abstract

Background The delivery of orthopaedic care via telemedicine services has the potential to promote accessibility and decrease medical care expenses, while facilitating the control of infectious disease spreading. The purpose of this study was to assess agreement regarding diagnosis, recommended course of management and the perceived need for additional diagnostic testing between a video examination (VE) and a face to face (FTF) assessment of patients with shoulder disorders. Methods Forty-seven (18 females) patients presenting to a shoulder surgery clinic were assessed consecutively by VE and a FTF examination. All assessments were conducted by a shoulder specialist. Agreement regarding the established diagnosis, the recommended course of management and the need for additional diagnostic tests was assessed using percent agreement and kappa (95% CI) coefficient. Differences in the content, duration and satisfaction between the two examination modes were also assessed. Results Percent agreement and kappa (95% CI) coefficient for agreement regarding diagnosis were 85.1% and 0.82 (0.69-0.94), respectively. Percent agreement and kappa (95% CI) coefficient regarding the recommended course of management and the need for additional diagnostic testing were 61.7% and 0.43 (0.22-0.63), and 74.5% and 0.49 (0.25-0.74), respectively. The VE resulted in collection of less physical examination information, took longer to complete and was associated with less satisfaction by both patient and examiner. Conclusions Video examination of patients with shoulder disorders may present a valid alternative to FTF examination. Nevertheless, the content of the video-based physical examination may need to be modified to facilitate a clearer detection of indications for specific interventions or diagnostic tests.

The effect of Covid-19 on the willingness to use video consultations among orthopedic and trauma outpatients: a multi-center survey in 1400 outpatients

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Remote Musculoskeletal Consultations: A Survey of General Practitioner Registrars’ Level of Confidence, Acceptability, and Management

“…Literature is now emerging to offer guidance and strategies to effectively implement remote primary care consultations [ 23 , 24 ]. Furthermore, guidance specific to remote MSK consultations is now being developed, such as virtual joint assessment guides and solutions to enable clinicians to provide satisfactory patient care [ 25 - 27 ]. Such resources may help to address the poor satisfaction levels and tendency to order more investigations and refer more MSK patients to see a specialist as observed in this study.…”

Die Videosprechstunde in einer unfallchirurgisch/orthopädischen Spezialsprechstunde

“…In Schweden etwa werden zur Reduktion der Arztbesuche vermehrt E‑Health-Lösungen verwendet [ 15 ]. In den USA wurden für orthopädische Sprechstunden in Zeiten von COVID-19 spezielle Fragebogen zur Untersuchung der Patienten mittels Videosprechstunde entwickelt [ 17 , 18 , 25 ]. In Deutschland hat selbst im Rahmen der Coronapandemie das Angebot von Onlinesprechstunden wie Chats oder Videosprechstunden zu Beginn nur gering zugenommen [ 19 ].…”