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A retrospective cohort study of telephone versus face-to-face clinics for the management of new otology referrals
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  • Christopher Metcalfe,
  • Peter Gaskell,
  • Thomas McLelland,
  • Sanjay Patel,
  • Jameel Muzaffar,
  • Lucy Dalton,
  • Chris Coulson
Christopher Metcalfe
University Hospitals Birmingham NHS Foundation Trust
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Peter Gaskell
University Hospitals Birmingham NHS Foundation Trust
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Thomas McLelland
University Hospitals Birmingham NHS Foundation Trust
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Sanjay Patel
University Hospitals Birmingham NHS Foundation Trust
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Jameel Muzaffar
Cambridge University Hospitals NHS Foundation Trust
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Lucy Dalton
University Hospitals Birmingham NHS Foundation Trust
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Chris Coulson
University Hospitals Birmingham NHS Foundation Trust
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Abstract

Objectives: To compare outcomes of telephone and face-to-face consultations for new otology referrals and discuss the wider use of telemedicine in otology. Design: Retrospective cohort study. Setting: UK secondary/tertiary referral unit. Participants: New adult otology referrals to our unit, sampled consecutively between March 2021 and May 2021, reviewed in either a face-to-face or telephone clinic. Main outcome measures: Primary outcome measure was the proportion of patients with a definitive management outcome (discharged or added to waiting list for treatment) versus the proportion of patients requiring follow-up for further assessment or review. Results: 150 new patients referred for a routine otology consultation (75 telephone, 75 face-to-face) were included. 53/75 patients (71%) undergoing a face-to-face consultation received a definitive outcome following initial review, versus 22/75 (29%) telephone patients (2 <0.001, OR 5.8). 52/75 (69%) telephone patients were followed up face-to-face for examination. The mean (SD) number of appointments required to reach a definitive outcome was 1.22 (0.58) and 1.75 (0.73) in the face-to-face and telephone cohorts respectively (p<0.001). Conclusion: Telephone clinics in otology have played an important role as part of the COVID19 response. However, they are currently limited by a lack of clinical examination and audiometry. Remote assessment pathways in otology that incorporate asynchronous review of recorded examinations alongside audiometry, either conventional or boothless, may mitigate this problem, however further research is required.
14 Jun 2022Submitted to Clinical Otolaryngology
17 Jun 2022Assigned to Editor
17 Jun 2022Submission Checks Completed
18 Jun 2022Reviewer(s) Assigned