Michelle A Cottrell1, Shaun P O'Leary2, Patrick Swete-Kelly3, Bula Elwell4, Sally Hess3, Mary-Ann Litchfield3, Ian McLoughlin4, Rebecca Tweedy3, Maree Raymer5, Anne J Hill6, Trevor G Russell6. 1. School of Health & Rehabilitation Sciences, University of Queensland, St Lucia, 4072, Australia; Physiotherapy Department, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, 4029, Australia. Electronic address: Michelle.cottrell@uqconnect.edu.au. 2. School of Health & Rehabilitation Sciences, University of Queensland, St Lucia, 4072, Australia; Physiotherapy Department, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, 4029, Australia. 3. Physiotherapy Department, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, 4029, Australia. 4. Physiotherapy Department, Ipswich Hospital, Chelmsford Avenue, Ipswich, 4305, Australia. 5. State-wide Neurosurgical and Orthopaedic Physiotherapy Screening Clinic & Multidisciplinary Service, Royal Brisbane & Women's Hospital, Butterfield Street, Herston, 4029, Australia. 6. School of Health & Rehabilitation Sciences, University of Queensland, St Lucia, 4072, Australia.
Abstract
OBJECTIVE: To determine the level of agreement between a telehealth and in-person assessment of a representative sample of patients with chronic musculoskeletal conditions referred to an advanced-practice physiotherapy screening clinic. DESIGN: Repeated-measures study design. PARTICIPANTS: 42 patients referred to the Neurosurgical & Orthopaedic Physiotherapy Screening Clinic (Queensland, Australia) for assessment of their chronic lumbar spine, knee or shoulder condition. INTERVENTION: Participants underwent two consecutive assessments by different physiotherapists within a single clinic session. In-person assessments were conducted as per standard clinical practice. Telehealth assessments took place remotely via videoconferencing. Six Musculoskeletal Physiotherapists were paired together to perform both assessment types. MAIN OUTCOME MEASURES: Clinical management decisions including (i) recommended management pathways, (ii) referral to allied health professions, (iii) clinical diagnostics, and (iv) requirement for further investigations were compared using reliability and agreement statistics. RESULTS: There was substantial agreement (83.3%; 35/42 cases) between in-person and telehealth assessments for recommended management pathways. Moderate to near perfect agreement (AC1 = 0.58-0.9) was reached for referral to individual allied health professionals. Diagnostic agreement was 83.3% between the two delivery mediums, whilst there was substantial agreement (81%; AC1 = 0.74) when requesting further investigations. Overall, participants were satisfied with the telehealth assessment. CONCLUSION: There is a high level of agreement between telehealth and in-person assessments with respect to clinical management decisions and diagnosis of patients with chronic musculoskeletal conditions managed in an advanced-practice physiotherapy screening clinic. Telehealth can be considered as a viable and effective medium to assess those patients who are unable to attend these services in person. Crown
OBJECTIVE: To determine the level of agreement between a telehealth and in-person assessment of a representative sample of patients with chronic musculoskeletal conditions referred to an advanced-practice physiotherapy screening clinic. DESIGN: Repeated-measures study design. PARTICIPANTS: 42 patients referred to the Neurosurgical & Orthopaedic Physiotherapy Screening Clinic (Queensland, Australia) for assessment of their chronic lumbar spine, knee or shoulder condition. INTERVENTION: Participants underwent two consecutive assessments by different physiotherapists within a single clinic session. In-person assessments were conducted as per standard clinical practice. Telehealth assessments took place remotely via videoconferencing. Six Musculoskeletal Physiotherapists were paired together to perform both assessment types. MAIN OUTCOME MEASURES: Clinical management decisions including (i) recommended management pathways, (ii) referral to allied health professions, (iii) clinical diagnostics, and (iv) requirement for further investigations were compared using reliability and agreement statistics. RESULTS: There was substantial agreement (83.3%; 35/42 cases) between in-person and telehealth assessments for recommended management pathways. Moderate to near perfect agreement (AC1 = 0.58-0.9) was reached for referral to individual allied health professionals. Diagnostic agreement was 83.3% between the two delivery mediums, whilst there was substantial agreement (81%; AC1 = 0.74) when requesting further investigations. Overall, participants were satisfied with the telehealth assessment. CONCLUSION: There is a high level of agreement between telehealth and in-person assessments with respect to clinical management decisions and diagnosis of patients with chronic musculoskeletal conditions managed in an advanced-practice physiotherapy screening clinic. Telehealth can be considered as a viable and effective medium to assess those patients who are unable to attend these services in person. Crown
Authors: David Hohenschurz-Schmidt; Whitney Scott; Charlie Park; Georgios Christopoulos; Steven Vogel; Jerry Draper-Rodi Journal: Schmerz Date: 2022-07-14 Impact factor: 1.629