title: Could a low-cost audio-visual link be useful in rheumatology?
abstract: 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.
authors.affiliation: Department of Rheumatology, Musgrave Park Hospital, Belfast, UK.
authors.forename: L E
authors.initials: LE
authors.lastname: Graham
authors.forename: S
authors.initials: S
authors.lastname: McGimpsey
authors.forename: S
authors.initials: S
authors.lastname: Wright
authors.forename: G
authors.initials: G
authors.lastname: McClean
authors.forename: J
authors.initials: J
authors.lastname: Carser
authors.forename: M
authors.initials: M
authors.lastname: Stevenson
authors.forename: R
authors.initials: R
authors.lastname: Wootton
authors.forename: A J
authors.initials: AJ
authors.lastname: Taggart
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011446:Prospective Studies; D019114:Remote Consultation / Q000191:economics / Q000592:standards*; D012216:Rheumatic Diseases / Q000175:diagnosis* / Q000191:economics; D017216:Telemedicine / Q000191:economics / Q000592:standards*