Telemedicine in remote orthopaedic consultations: A randomised controlled trial
Decentralised services using outreach clinics or modern technology are methods to reduce the patient burden by reducing transport time and costs to the health care system. The aim of this study was to evaluate the quality of planned remote orthopaedic consultations with the help of videoconferences....
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UiT The Arctic University of Norway
2020
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Online Access: | https://hdl.handle.net/10037/19324 |
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ftunivtroemsoe:oai:munin.uit.no:10037/19324 2023-05-15T17:39:25+02:00 Telemedicine in remote orthopaedic consultations: A randomised controlled trial Buvik, Astrid Synnøve 2020-09-25 https://hdl.handle.net/10037/19324 eng eng UiT The Arctic University of Norway UiT Norges arktiske universitet Paper I: Buvik, A., Bugge, E., Knutsen, G., Småbrekke, A. & Wilsgaard, T. (2016). Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial. BMC Health Services Research, 16 , 483. Also available in Munin at https://hdl.handle.net/10037/10738 . Paper II: Buvik, A., Bugge, E., Knutsen, G., Småbrekke, A. & Wilsgaard, T. (2019). Patient reported outcomes with remote orthopaedic consultation by using telemedicine: A randomised controlled trial. Journal of Telemedicine and Telecare, 25 (8), 451-459. Also available at https://doi.org/10.1177%2F1357633X18783921 . Paper III: Buvik, A., Bergmo, T.S., Bugge, E., Småbrekke, A., Wilsgaard, T. & Olsen, J.A. (2019). Cost-effectiveness of telemedicine in remote orthopedic consultations: Randomized controlled trial. Journal of Medical Internet Research, 21 (2), e11330. Also available in Munin at https://hdl.handle.net/10037/14877 . https://hdl.handle.net/10037/19324 openAccess Copyright 2020 The Author(s) VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Ortopedisk kirurgi: 784 VDP::Medical disciplines: 700::Health sciences: 800::Health service and health administration research: 806 DOKTOR-003 Doctoral thesis Doktorgradsavhandling 2020 ftunivtroemsoe 2021-06-25T17:57:39Z Decentralised services using outreach clinics or modern technology are methods to reduce the patient burden by reducing transport time and costs to the health care system. The aim of this study was to evaluate the quality of planned remote orthopaedic consultations with the help of videoconferences. From 2007 to 2012, we performed a randomised controlled trial (RCT) with two parallel groups: video-assisted remote consultations at a regional medical centre (RMC) (intervention) versus standard consultation in the orthopaedic outpatient clinic at the University Hospital of North Norway (UNN) ( control). The participants had been referred to or were scheduled for a consultation at the orthopaedic outpatient clinic. The orthopaedic surgeons evaluated each consultation they performed by completing a questionnaire, with five five-level questions, each measuring five categories of experience. The primary outcome was the sum score calculated from this questionnaire, which was evaluated by the non-inferiority of the intervention group. The study design was based on the intention to treat principle. The secondary outcomes were patient satisfaction and cost effectiveness. The sum score of the specialist evaluation was significantly lower (i.e. “better”) at UNN compared to the RMC but was within the non-inferiority margin. The orthopaedic surgeons involved evaluated 98% of the video-assisted consultations as “good” or “very good” and equal to a standard consultation. In the ancillary analyses concerning professional quality, no significant difference between the two groups was noted. We did not observe any significant difference in patient-reported health outcomes (EQ-5D; EQ VAS). In terms of patient satisfaction, a significantly higher proportion of patients preferred remote consultation as their next consultation. We found that telemedicine service in this setting is cost-effective from societal and health sector perspectives. The study demonstrated that video-assisted consultations for selected orthopaedic patients is preferred to standard consultation in terms of clinician reported quality, patient-reported health outcomes and cost-effectiveness. Doctoral or Postdoctoral Thesis North Norway University of Tromsø: Munin Open Research Archive Norway |
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Open Polar |
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University of Tromsø: Munin Open Research Archive |
op_collection_id |
ftunivtroemsoe |
language |
English |
topic |
VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Ortopedisk kirurgi: 784 VDP::Medical disciplines: 700::Health sciences: 800::Health service and health administration research: 806 DOKTOR-003 |
spellingShingle |
VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Ortopedisk kirurgi: 784 VDP::Medical disciplines: 700::Health sciences: 800::Health service and health administration research: 806 DOKTOR-003 Buvik, Astrid Synnøve Telemedicine in remote orthopaedic consultations: A randomised controlled trial |
topic_facet |
VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Ortopedisk kirurgi: 784 VDP::Medical disciplines: 700::Health sciences: 800::Health service and health administration research: 806 DOKTOR-003 |
description |
Decentralised services using outreach clinics or modern technology are methods to reduce the patient burden by reducing transport time and costs to the health care system. The aim of this study was to evaluate the quality of planned remote orthopaedic consultations with the help of videoconferences. From 2007 to 2012, we performed a randomised controlled trial (RCT) with two parallel groups: video-assisted remote consultations at a regional medical centre (RMC) (intervention) versus standard consultation in the orthopaedic outpatient clinic at the University Hospital of North Norway (UNN) ( control). The participants had been referred to or were scheduled for a consultation at the orthopaedic outpatient clinic. The orthopaedic surgeons evaluated each consultation they performed by completing a questionnaire, with five five-level questions, each measuring five categories of experience. The primary outcome was the sum score calculated from this questionnaire, which was evaluated by the non-inferiority of the intervention group. The study design was based on the intention to treat principle. The secondary outcomes were patient satisfaction and cost effectiveness. The sum score of the specialist evaluation was significantly lower (i.e. “better”) at UNN compared to the RMC but was within the non-inferiority margin. The orthopaedic surgeons involved evaluated 98% of the video-assisted consultations as “good” or “very good” and equal to a standard consultation. In the ancillary analyses concerning professional quality, no significant difference between the two groups was noted. We did not observe any significant difference in patient-reported health outcomes (EQ-5D; EQ VAS). In terms of patient satisfaction, a significantly higher proportion of patients preferred remote consultation as their next consultation. We found that telemedicine service in this setting is cost-effective from societal and health sector perspectives. The study demonstrated that video-assisted consultations for selected orthopaedic patients is preferred to standard consultation in terms of clinician reported quality, patient-reported health outcomes and cost-effectiveness. |
format |
Doctoral or Postdoctoral Thesis |
author |
Buvik, Astrid Synnøve |
author_facet |
Buvik, Astrid Synnøve |
author_sort |
Buvik, Astrid Synnøve |
title |
Telemedicine in remote orthopaedic consultations: A randomised controlled trial |
title_short |
Telemedicine in remote orthopaedic consultations: A randomised controlled trial |
title_full |
Telemedicine in remote orthopaedic consultations: A randomised controlled trial |
title_fullStr |
Telemedicine in remote orthopaedic consultations: A randomised controlled trial |
title_full_unstemmed |
Telemedicine in remote orthopaedic consultations: A randomised controlled trial |
title_sort |
telemedicine in remote orthopaedic consultations: a randomised controlled trial |
publisher |
UiT The Arctic University of Norway |
publishDate |
2020 |
url |
https://hdl.handle.net/10037/19324 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
North Norway |
genre_facet |
North Norway |
op_relation |
Paper I: Buvik, A., Bugge, E., Knutsen, G., Småbrekke, A. & Wilsgaard, T. (2016). Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial. BMC Health Services Research, 16 , 483. Also available in Munin at https://hdl.handle.net/10037/10738 . Paper II: Buvik, A., Bugge, E., Knutsen, G., Småbrekke, A. & Wilsgaard, T. (2019). Patient reported outcomes with remote orthopaedic consultation by using telemedicine: A randomised controlled trial. Journal of Telemedicine and Telecare, 25 (8), 451-459. Also available at https://doi.org/10.1177%2F1357633X18783921 . Paper III: Buvik, A., Bergmo, T.S., Bugge, E., Småbrekke, A., Wilsgaard, T. & Olsen, J.A. (2019). Cost-effectiveness of telemedicine in remote orthopedic consultations: Randomized controlled trial. Journal of Medical Internet Research, 21 (2), e11330. Also available in Munin at https://hdl.handle.net/10037/14877 . https://hdl.handle.net/10037/19324 |
op_rights |
openAccess Copyright 2020 The Author(s) |
_version_ |
1766140186308116480 |