PMID- 34352098
OWN - NLM
STAT- MEDLINE
DCOM- 20220509
LR  - 20220525
IS  - 1462-0332 (Electronic)
IS  - 1462-0324 (Print)
IS  - 1462-0324 (Linking)
VI  - 61
IP  - 5
DP  - 2022 May 5
TI  - Telemedicine in rheumatology: high specificity and sensitivity of follow-up 
      virtual video consultations during COVID-19 pandemic.
PG  - 1795-1801
LID - 10.1093/rheumatology/keab632 [doi]
LID - keab632
AB  - OBJECTIVE: To evaluate the reliability of virtual video-assisted visits, added to 
      the tight-control strategy for inflammatory rheumatic diseases (IRDs), in 
      identifying patients who need treatment adjustment. METHODS: Tightly followed-up 
      adult patients with RA, PsA, AS or SLE took part in a video consultation during 
      COVID19 lockdown and repeated the same rheumatology evaluations through a 
      face-to-face visit within 2 weeks. The sensitivity and specificity of the virtual 
      visits for treatment decisions (categorized as: unchanged, adjusted/escalated, 
      tapered/discontinued, need for further examinations), and the intraclass 
      correlation coefficient (ICC) for virtually measured disease activity and 
      patient-reported outcomes (PROs) were calculated with 95% CIs using face-to-face 
      visits as the reference method. RESULTS: In 89 out of 106 patients (84.0%), 
      face-to-face visits confirmed the remotely delivered treatment decision. 
      Video-visiting showed excellent sensitivity (94.1% with 95% CI: 71.3%, 99.9%) and 
      specificity (96.7%; 95% CI: 90.8%, 99.3%) in identifying the need for treatment 
      adjustment due to inadequate disease control. The major driver for the low 
      sensitivity of virtual video consultation (55.6%; 95% CI: 21.2%, 86.3%) in 
      identifying the need for treatment tapering was SLE diagnosis [odds ratio (OR) 
      10.0; 95% CI: 3.1, 32.3; P <0.001], mostly because of discordance with 
      face-to-face consultation in glucocorticoid tapering. Remotely evaluated PROs 
      showed high reliability (ICC range 0.80-0.95), while disease activity measures 
      had less consistent data (ICC range 0.50-0.95), especially for those diseases 
      requiring more extensive physical examination, such as in SLE and PsA. 
      CONCLUSION: Video-visiting proved to have high reliability in identifying the 
      need for treatment adjustment and might support the IRDs standard tight-control 
      strategy.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      British Society for Rheumatology. All rights reserved. For permissions, please 
      email: journals.permissions@oup.com.
FAU - Piga, Matteo
AU  - Piga M
AUID- ORCID: 0000-0002-1126-8315
AD  - Rheumatology Unit, University Clinic AOU Cagliari, Monserrato, CA.
AD  - Department of Medical Sciences and Public Health, University of Cagliari, 
      Cagliari, Italy.
FAU - Floris, Alberto
AU  - Floris A
AD  - Rheumatology Unit, University Clinic AOU Cagliari, Monserrato, CA.
AD  - Department of Medical Sciences and Public Health, University of Cagliari, 
      Cagliari, Italy.
FAU - Congia, Mattia
AU  - Congia M
AD  - Rheumatology Unit, University Clinic AOU Cagliari, Monserrato, CA.
AD  - Department of Medical Sciences and Public Health, University of Cagliari, 
      Cagliari, Italy.
FAU - Chessa, Elisabetta
AU  - Chessa E
AD  - Rheumatology Unit, University Clinic AOU Cagliari, Monserrato, CA.
AD  - Department of Medical Sciences and Public Health, University of Cagliari, 
      Cagliari, Italy.
FAU - Cangemi, Ignazio
AU  - Cangemi I
AD  - Rheumatology Unit, University Clinic AOU Cagliari, Monserrato, CA.
AD  - Department of Medical Sciences and Public Health, University of Cagliari, 
      Cagliari, Italy.
FAU - Cauli, Alberto
AU  - Cauli A
AD  - Rheumatology Unit, University Clinic AOU Cagliari, Monserrato, CA.
AD  - Department of Medical Sciences and Public Health, University of Cagliari, 
      Cagliari, Italy.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Rheumatology (Oxford)
JT  - Rheumatology (Oxford, England)
JID - 100883501
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Adult
MH  - *COVID-19/epidemiology
MH  - Communicable Disease Control
MH  - Follow-Up Studies
MH  - Humans
MH  - *Lupus Erythematosus, Systemic/diagnosis/therapy
MH  - Male
MH  - Pandemics
MH  - Prostate-Specific Antigen
MH  - Referral and Consultation
MH  - Reproducibility of Results
MH  - *Rheumatology
MH  - *Telemedicine/methods
PMC - PMC8436393
OTO - NOTNLM
OT  - ankylosing spondylitis
OT  - inflammatory arthritis
OT  - psoriatic arthritis
OT  - rheumatoid arthritis
OT  - systemic lupus erythematosus
OT  - telemedicine
OT  - tight control
OT  - video-visiting
EDAT- 2021/08/06 06:00
MHDA- 2022/05/10 06:00
PMCR- 2021/08/05
CRDT- 2021/08/05 17:27
PHST- 2021/05/17 00:00 [received]
PHST- 2021/07/16 00:00 [revised]
PHST- 2021/08/06 06:00 [pubmed]
PHST- 2022/05/10 06:00 [medline]
PHST- 2021/08/05 17:27 [entrez]
PHST- 2021/08/05 00:00 [pmc-release]
AID - 6342429 [pii]
AID - keab632 [pii]
AID - 10.1093/rheumatology/keab632 [doi]
PST - ppublish
SO  - Rheumatology (Oxford). 2022 May 5;61(5):1795-1801. doi: 
      10.1093/rheumatology/keab632.