title: Validity Study of Video Teleconsultation for the Management of Diabetes: A Pilot Randomized Controlled Trial.
abstract: BACKGROUND
  A large proportion of diabetes patients do not receive a basic minimum of standard care. Telemedicine holds the promise of improving access to health care. However, the validity of remote consultation for diabetes has not been well researched. This pilot randomized control trial was designed to evaluate the agreement on prescription decisions of endocrinologists between two consultation formats: videoconferencing and face-to-face (in-person) consultation.
  
  
  METHODS
  Seventy-three patients were randomized to telemedicine (n=36) and reference group (n=37). Each study patient in the telemedicine group received one face-to-face consultation and one video consultation. The reference group received two face-to-face consultations. The paired consultations for each patient were performed by two different endocrinologists. The level of agreement between endocrinologists was evaluated by comparing their recommendations on antidiabetes and cardioprotective medications.
  
  
  RESULTS
  The level of agreement between two endocrinologists on changing antidiabetes drugs was 64% in the telemedicine group and 78% in the reference group. Although the level of agreement was lower when one of the consultations was provided via videoconference, the difference was not significant. The level of agreement on changing cardiovascular drugs was 78% in the telemedicine group and 76% in the reference group, again not significantly different.
  
  
  CONCLUSIONS
  The results of this study demonstrate the preliminary evidence on the validity of recommendations made by endocrinologists via video consultation. Known limitations of videoconferencing for clinical purposes did not have remarkable impact on the outcome of consultation in terms of adjustment of patient's medications. Video teleconsultation can substitute for a considerable proportion of conventional outpatient specialty consultations for people with diabetes.
authors.affiliation: 1 Centre for Online Health, The University of Queensland , Brisbane, Australia .|2 School of Advanced Technologies in Medicine, Tehran University of Medical Sciences , Tehran, Iran .
authors.forename: Farhad
authors.initials: F
authors.lastname: Fatehi
authors.affiliation: 1 Centre for Online Health, The University of Queensland , Brisbane, Australia .
authors.forename: Leonard C
authors.initials: LC
authors.lastname: Gray
authors.affiliation: 3 Diabetes and Endocrinology Department, Princess Alexandra Hospital , Brisbane, Australia .|4 School of Medicine, The University of Queensland , Brisbane, Australia .
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Russell
authors.affiliation: 5 Clinical Trials & Biostatistics Unit, QIMR Berghofer Medical Research Institute , Brisbane, Australia .
authors.forename: Sanjoy K
authors.initials: SK
authors.lastname: Paul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D019114:Remote Consultation / Q000379:methods*; D049269:Videoconferencing; D055815:Young Adult