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Delivery of remote otology care: a UK pilot feasibility study.
Forde, Cillian T; Dimitrov, Lilia; Doal, Suneal; Patel, Jay; Clare, Dawn; Burslem, Michael; Mehta, Nishchay; Manjaly, Joseph G.
  • Forde CT; ENT Department, Royal National Throat Nose and Ear Hospital, London, UK.
  • Dimitrov L; ENT Department, Royal National Throat Nose and Ear Hospital, London, UK.
  • Doal S; evidENT Ucl Ear Institute, University College London, London, UK.
  • Patel J; National Institute of Health Research University College London Hospitals Biomedical Research Centre, London, UK.
  • Clare D; Department of Audiology, Royal National ENT & Eastman Dental Hospitals, London, UK.
  • Burslem M; Department of Audiology, Royal National ENT & Eastman Dental Hospitals, London, UK.
  • Mehta N; Department of Audiology, Royal National ENT & Eastman Dental Hospitals, London, UK.
  • Manjaly JG; ENT Department, Royal National Throat Nose and Ear Hospital, London, UK.
BMJ Open Qual ; 11(1)2022 02.
Article in English | MEDLINE | ID: covidwho-1685601
ABSTRACT

INTRODUCTION:

The COVID-19 pandemic has catalysed the need to implement the National Health Service Long-Term Plan to deliver more care in the community and to reduce face-to-face hospital appointments by up to 33%. This study aimed to assess the feasibility of a remote otology service from triage through to delivery.

METHODS:

New adult otology referrals at a tertiary ear, nose and throat (ENT) hospital aged between 18 and 70 with hearing loss or tinnitus were included. Patients attended an audiology-led community clinic where they underwent a focused history, audiometric testing, and a smartphone-based application and otoscope (Tympa System) was used to capture still and video images of their eardrums. The information was reviewed by ENT clinicians using a remote review platform with a subset of patients subsequently undergoing an in-person review to measure concordance between the two assessments.

RESULTS:

58 patients participated. 75% of patients had their pathways shortened by one hospital visit with 65% avoiding any hospital attendances. 24% required an additional face-to-face appointment due to incomplete views of the tympanic membrane or need for additional examinations. Electronic validation by a blinded consultant otologist demonstrated a diagnosis concordance of 95%, and concordance between remote-review and in-person consultations in the 12 patients who agreed to attend for an in-person review was 83.3%. 98% of patients were satisfied with the pathway.

CONCLUSION:

This pilot service is feasible, safe and non-inferior to the traditional outpatient model in the included patient group. There is potential for the development of a community audiology-led service or use for general practioner advice and guidance.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Otolaryngology / COVID-19 Type of study: Prognostic study Limits: Adolescent / Adult / Aged / Humans / Middle aged / Young adult Country/Region as subject: Europa Language: English Year: 2022 Document Type: Article Affiliation country: Bmjoq-2021-001444

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Otolaryngology / COVID-19 Type of study: Prognostic study Limits: Adolescent / Adult / Aged / Humans / Middle aged / Young adult Country/Region as subject: Europa Language: English Year: 2022 Document Type: Article Affiliation country: Bmjoq-2021-001444