The role of teleconsultation in the management of suspected skin malignancy in plastic surgery during COVID-19 outbreak
Published Date: 18th March 2021
Publication Authors: Koysombat K, Plonczak AM, West C
Abstract
The COVID-19 pandemic has had a profound impact on the provision of skin cancer treatment in the UK. To preserve the service, the department transformed the outpatient skin cancer clinic into teleclinic service. This study examines the safety and efficacy of a teleclinic consultation, in comparison to a face-to-face consultation. We assessed efficacy in terms of accuracy of the clinical diagnosis in comparison to the histopathological result and whether treatment was designated the appropriate clinical priority/urgency. A total of 120 lesions in 98 patients were assessed, 55 patients in the face-to-face clinic cohort, and 43 patients in the teleclinic cohort. Diagnostic accuracy was better in face-to-face clinic compared to teleclinic; 85.0% and 63.6% respectively (χ2 (1, N = 120) = 7.35, p = 0.0067). The accuracy of listing patients on the correct pathway was slightly higher for teleclinic patients. Of the teleclinic patients listed through the urgent pathway, 45.7% justified their urgent status, compared with 37.5% of those listed urgent in face-to-face clinic (p = 0.67). For those listed as routine, 100% of teleclinic patients were listed appropriately whereas the accuracy was 96.8% for the face-to-face clinic counterpart. In conclusion, despite teleclinic having slightly reduced diagnostic accuracy, teleclinics show comparable accuracy in listing patients to urgent or routine skin cancer pathways. It offers convenience to patients in addition to reducing time to treatment and cost effectiveness. The lessons learned in the pandemic can be applied to the post-COVID healthcare environment.
Koysombat, K; Plonczak, AM; West, CA. (2021). The role of teleconsultation in the management of suspected skin malignancy in plastic surgery during COVID-19 outbreak: A single centre experience. JPRAS: Journal of plastic, reconstructive, and aesthetic surgery. epub 18 Mar