The use of telemedicine in pre-surgical evaluation: a retrospective cohort study of a neurosurgical oncology practice

• Published in: Journal of neuro-oncology Vol. 159; no. 3; pp. 621 - 626
• Main Authors: Smit, Rupert D., Mouchtouris, Nikolaos, Reyes, Maikerly, Piper, Keenan, Yu, Siyuan, Collopy, Sarah, Nelson, Nicolas, Prashant, Giyarpuram, Farrell, Christopher, Evans, James J.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2022; Springer Nature B.V
• Subjects: Brain cancer; Cohort analysis; Humans; Medical Oncology; Medicine; Medicine & Public Health; Neurology; Neurosurgery; Neurosurgical Procedures; Oncology; Patients; Radiosurgery; Retrospective Studies; Surgery; Telemedicine; Tumors; Brain tumor; Telemedicine; Conversion rate; Pituitary adenoma
• ISSN: 0167-594X; 1573-7373; 1573-7373
• DOI: 10.1007/s11060-022-04102-8

Purpose To determine if there was a discrepancy between telemedicine versus in-person New Patient Visits (NPVs) regarding the conversion rate to operative and radiosurgery cases at a tertiary surgical neuro-oncology practice. Methods A retrospective analysis was performed of patients who had an outpatient encounter with a neurosurgeon from the Tumor Division at our institution’s Department of Neurosurgery between February 1, 2021 and April 30, 2021. NPVs during this period were registered as either telemedicine or in-person appointments. The primary endpoint of the study was to compare the rate at which telemedicine NPVs and in-person NPVs underwent surgery or radiosurgery, reported as the surgical conversion rate. Results A total of 206 patients were included in this study. Of them, 119 (57.8%) were seen using telemedicine and 87 (42.2%) were seen in clinic via an in-person visit. A total of 70 (34%) of all patients underwent surgery or radiosurgery. Of the 119 patients seen via telemedicine, 40 (33.6%) underwent surgery or radiosurgery; during the same period, 87 NPVs were conducted in person and 30 (34.5%, p = 1.0) received an intervention. Further stratification revealed no differences between the two groups across measured criteria including diagnosis, number of pre-operative visits, elapsed time from appointment to surgery, follow-up visits, and distance from home address to neurosurgical clinic. Conclusion Telemedicine NPVs did not differ significantly from in-person NPVs when evaluating the likelihood of a new patient committing to surgical treatment. This study provides quantifiable evidence that telemedicine is an effective means of meeting new patients and planning complex neurosurgical interventions.