Stepwise asynchronous telehealth assessment of patients with suspected axial spondyloarthritis: results from a pilot study

Labinsky H, von Rohr S, Raimondo MG, Bohr D, Morf H, Horstmann B, Seese F, Proft F, Muehlensiepen F, Boy K, Kuhn S, Schmalzing M, Vuillerme N, Schett G, Ramming A, Knitza J (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Rheumatology International Springer Verlag (Germany)

DOI: 10.1007/s00296-023-05360-z

Abstract

Patients with axial spondyloarthritis (axSpA) suffer from one of the longest diagnostic delays among all rheumatic diseases. Telemedicine (TM) may reduce this diagnostic delay by providing easy access to care. Diagnostic rheumatology telehealth studies are scarce and largely limited to traditional synchronous approaches such as resource-intensive video and telephone consultations. The aim of this study was to investigate a stepwise asynchronous telemedicine-based diagnostic approach in patients with suspected axSpA. Patients with suspected axSpA completed a fully automated digital symptom assessment using two symptom checkers (SC) (bechterew-check and Ada). Secondly, a hybrid stepwise asynchronous TM approach was investigated. Three physicians and two medical students were given sequential access to SC symptom reports, laboratory and imaging results. After each step, participants had to state if axSpA was present or not (yes/no) and had to rate their perceived decision confidence. Results were compared to the final diagnosis of the treating rheumatologist. 17 (47.2%) of 36 included patients were diagnosed with axSpA. Diagnostic accuracy of bechterew-check, Ada, TM students and TM physicians was 47.2%, 58.3%, 76.4% and 88.9% respectively. Access to imaging results significantly increased sensitivity of TM-physicians (p < 0.05). Mean diagnostic confidence of false axSpA classification was not significantly lower compared to correct axSpA classification for both students and physicians. This study underpins the potential of asynchronous physician-based telemedicine for patients with suspected axSpA. Similarly, the results highlight the need for sufficient information, especially imaging results to ensure a correct diagnosis. Further studies are needed to investigate other rheumatic diseases and telediagnostic approaches.

Authors with CRIS profile

Hannah Labinsky Department of Medicine 3 – Rheumatology and Immunology Maria Gabriella Raimondo Department of Medicine 3 – Rheumatology and Immunology Harriet Morf Department of Medicine 3 – Rheumatology and Immunology Felix Seese Medizinische Fakultät Georg Schett Lehrstuhl für Innere Medizin III Andreas Ramming Professur für Immunologie der Organschädigung Johannes Knitza Department of Medicine 3 – Rheumatology and Immunology

Involved external institutions

University of Grenoble Alpes (UGA) / Université de Grenoble FR France (FR) Universitätsklinikum Würzburg DE Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) DE Germany (DE) Medizinische Hochschule Brandenburg "Theodor Fontane" / Brandenburg Medical School "Theodor Fontane" DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE)

How to cite

APA:

Labinsky, H., von Rohr, S., Raimondo, M.G., Bohr, D., Morf, H., Horstmann, B.,... Knitza, J. (2023). Stepwise asynchronous telehealth assessment of patients with suspected axial spondyloarthritis: results from a pilot study. Rheumatology International. https://dx.doi.org/10.1007/s00296-023-05360-z

MLA:

Labinsky, Hannah, et al. "Stepwise asynchronous telehealth assessment of patients with suspected axial spondyloarthritis: results from a pilot study." Rheumatology International (2023).

BibTeX: Download