During the initial phases of the Covid-19 pandemic in 2020, delivery of ENT care adapted significantly. Kaleva et al present their findings of telephone balance consultations during the pandemic with a randomised prospective study utilising a dizziness questionnaire in West Suffolk. Their aim was to assess whether use of the Roland Dizziness Questionnaire (Roland et al 2015) aided diagnosis and reduced investigation / face-to-face review. Patients were randomised, 57 assigned to questionnaire (35 completed questionnaire) and 58 assigned no questionnaire (47 consulted). Five clinicians conducted the consultations via telephone with mean duration 13 minutes (no difference between two groups). No statistical difference was achieved for primary endpoint (likelihood of making diagnosis) between the two groups. They found statistically significant investigation outcomes, questionnaire group 9/35 and non-questionnaire 34/47 (p=0.0409) and again for telephone follow-up consultations, 6/35 and 20/47 (p=0.0173) respectively. Interestingly in their follow-up data analysis, when patients could attend face-to-face, 17/80 had a change of diagnosis. Limitations of the study include lack of blinding and an uneven rate of incomplete / unsuccessful consultations, in addition to the lack of physical examination that can aid diagnosis and allow for therapeutic treatment at face-to-face consultations. In conclusion, questionnaire use appears to have helped with some secondary endpoints (investigation and follow-up) but missed the primary endpoint of aiding diagnosis. It appears to be a somewhat useful adjunct for telemedicine.
Dizziness questionnaire and telemedicine during Covid pandemic
Reviewed by Aaron Ferguson
Evaluating a Questionnaire in Telephone Balance Consultations During the Coronavirus Disease 2019 Pandemic.
