Telemedicine in Nerve Surgery: An Effective Method to Determine Indications for Surgery

Area of Science:

• Neurosurgery
• Digital Health
• Health Services Research

Background:

• The COVID-19 pandemic spurred telemedicine adoption for surgical consultations.
• Limited research compares telemedicine effectiveness to in-office visits for surgical indication determination.
• This study addresses the gap in understanding telemedicine's role in surgical planning.

Purpose of the Study:

• To compare the effectiveness of telemedicine versus in-person consultations in establishing surgical plans.
• To evaluate if in-office visits are superior to telemedicine for surgical decision-making.
• To assess patient outcomes following surgical recommendations from both consultation types.

Main Methods:

• Retrospective review of 809 new nerve surgery patients (June 2020-January 2023).
• Categorization of consultations: surgery recommended, not recommended, further screening, or declined.
• Fisher exact test used to compare outcomes between in-person and telemedicine consultations.

Main Results:

• Surgery was recommended in 49.5% of in-person vs. 38% of telemedicine consultations (P=0.03).
• Ultimately, 77.9% of in-person and 77.8% of telemedicine patients recommended for surgery underwent the procedure (P=0.10).
• 84.5% of telemedicine patients subsequently seen in-office and offered surgery, underwent it.

Conclusions:

• Telemedicine and in-office visits demonstrate comparable effectiveness in surgical plan establishment.
• Telemedicine can be expanded to serve a wider geographic patient population.
• The findings support the integration of telemedicine in surgical care pathways.