Could a low-cost audio-visual link be useful in rheumatology?

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2000-05-25
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We have investigated prospectively the diagnostic accuracy specialist satisfaction and patient specialist rapport of a low cost audio visual link between a junior doctor with a patient and a consultant rheumatologist Using a telephone link and subsequently a video phone link 20 patients with various rheumatological problems were presented by a junior doctor to the consultant rheumatologist for provisional diagnosis All patients were then seen face to face by the consultant when a final diagnosis was made An independent consultant rheumatologist made a gold standard diagnosis Thirty five per cent of diagnoses were made correctly over the telephone and 40 over the video phone there was no significant difference in the diagnostic accuracy between these two methods of communication Rapport over the video phone was universally poor Where it was important clinical signs could not be visualized over the video phone and in more than 85 of cases small joint swellings could not be seen clearly
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