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E-consensus on telemedicine in proctology: A RAND/UCLA-modified study
Gaetano Gallo1, Ugo Grossi2, Alessandro Sturiale3
1Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
Surgery
|March 26, 2021
Summary
Telemedicine is not suitable for diagnosing common proctologic conditions but can be used for pilonidal disease. Experts recommend in-person assessments before surgery to avoid misdiagnosis risks.
Area of Science:
- Colorectal Surgery
- Digital Health
- Telemedicine Applications
Background:
- Investigating telemedicine's role in proctology amidst healthcare changes.
- Aiming for expert consensus on telemedicine applications in proctologic care.
Framework:
- Developed 55 clinical practice recommendations via expert consensus.
- Utilized RAND/UCLA methodology with 47 Italian Society of Colorectal Surgery experts.
- Conducted a two-round evaluation of recommendations by working group.
Implementation:
- Experts agreed on minimum 3-5 years proctologic experience for teleconsultations.
- Teleconsultations should be paid, with reports and prescriptions emailed to patients.
- 74% of panelists identified cancer misdiagnosis risk, recommending in-person pre-surgical assessment.
Implications:
- Telemedicine deemed inappropriate for common proctologic conditions and pelvic floor disorders.
- Teleconsultation found appropriate for pilonidal disease diagnosis and management.
- Highlighted the need for standardized infrastructure, logistics, and legal frameworks for telemedicine in Italy.
