Respiratory Tract Infections
Conditions
Keywords
Telemedicine, Respiratory Tract Infections, Emergency Medical Services, Referral and Consultation, COVID-19
Brief summary
This is a randomized study that sought to analyze the diagnostic accuracy of the telemedicine consultation of patients suspected of respiratory tract infections during COVID-19 pandemic in comparison with the face-to-face evaluation at the emergency department.
Detailed description
Unicentric, prospective and randomized study performed between September and November 2020 with adult patients who sought care at emergency department. The inclusion criterion was the exhibition of any tract respiratory symptom. Patients older than 65 years, with chronic heart or lung diseases or immunosuppressed were excluded. Eligible patients were randomized 1:1 for a brief telemedicine consultation, blinded to subsequent face-to-face evaluation or direct face-to-face evaluation.
Interventions
Brief telemedicine consultation, blinded to subsequent face-to-face evaluation.
Direct face-to-face evaluation (without telemedicine consultation before).
Sponsors
Hospital Israelita Albert Einstein
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients with at least one acute symptom compatible with RTI (sore throat, nasal obstruction, coryza, new or growing cough, sputum, hoarseness, dyspnea) in presence or absence of symptoms related to the infection (fever ≥ 38oC, chills, sweating, myalgia) that motivated spontaneously face-to-face evaluation at the ED.
Exclusion criteria
* Patients with diagnosis of chronic respiratory diseases (chronic obstructive pulmonary disease, asthma and interstitial lung disease) * Patients with previous diagnosis of congestive heart failure, * Patients with HIV / AIDS * Patients with active cancer * Patients with type I diabetes mellitus * Patients in use of any immunosuppressant * Patients with chronic cough * Patiets that referral to emergency room after nursing triage.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of final evaluation ICD 10-code diagnosis. | up to 10 months | All institutional Emergency Department or Telemedicine assessments involve filling out the final diagnosis on an International Classification of Diseases (ICD-10)-code basis in the electronic medical record before discharge to home or admission. For aggregation of most prevalent RTI with similar pathophysiologic characteristics, three diagnostic groups were defined, based on ICD 10 codes: RTI, including COVID-19 (B34.2, B34.9, B97.2, J00, J04, J06, J11, J20, J30, J39, U07.1); PT - Acute Pharyngotonsillitis (J02-J03.9) and AS - Acute Sinusitis (J01-J01.9). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time of medical care | up to 10 months | Comparison of time (minutes) of medical care between telemedicine and face-to-face consultation. |
| Rate of indication for complementary exams | up to 10 months | Comparison of rate (percentage) of indication for complementary exams between telemedicine and face-to-face consultation. |
| Type of requested exams | up to 10 months | Comparison of type of requested exams (porcentage) between telemedicine and face-to-face consultation. |
| Type of Medical prescription | up to 10 months | Comparison of type of medical prescription after completion of the service between telemedicine and face-to-face consultation |
| Type of proposed destination after completion of the service | up to 10 months | Comparison of proposed destination (percentage of discharge or hospitalization) after completion of the service between telemedicine and face-to-face consultation. |
Countries
Brazil
Outcome results
None listed