A retrospective cohort study of telephone versus face-to-face clinics
for the management of new otology referrals
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.