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 (χ2 <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.