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Objective: To evaluate the (cost-)effectiveness of online consultations in follow-up of patients with celiac disease (CD).
Study Design: Multicenter randomized, controlled trial involving 304 patients aged ≤25 years with CD for ≥1 year, randomized to an online (n = 156) or outpatient consultation (n = 148). An online consultation included questionnaires for symptom and growth measurement. Antitransglutaminase-type-2 antibodies were determined using a point-of-care (POC) test. Controls had a traditional consultation with antitransglutaminase-type-2 antibodies testing in laboratories. Both groups completed questionnaires concerning CD-specific health-related quality of life (HRQOL), gluten-free diet adherence, and patient satisfaction. Six months later, participants repeated HRQOL and patient satisfaction questionnaires and the POC test. The primary outcome was anti-transglutaminase-type-2 antibodies after 6 months, and the secondary outcomes were health problems, dietary adherence, HRQOL, patient satisfaction, and costs.
Results: The performance of the POC test was inferior to laboratory testing (2/156 positive POC tests vs 13/148 positive laboratory tests; P = .003). Health problems were detected significantly more frequently using online consultation. The detection of growth problems and dietary transgressions was similar. HRQOL (from 1 [good] to 5 [poor]) improved after online consultation (from 3.25 to 3.16 [P = .013] vs controls from 3.10 to 3.23; P = .810). Patient satisfaction (from 1 [low] to 10 [high]) was 7.6 (online) vs 8.0 (controls; P = .001); 58% wished to continue online consultations. Mean costs per participant during the studied period were €202 less for the online group (P < .001).
Conclusions: The primary outcome could not be tested because the POC test was unreliable. Nevertheless, our results indicate that online consultations for children and young adults with CD are cost saving, increase CD-specific HRQOL, and are satisfactory for the majority.
Trial Registration: Trialregister.nl: NTR3688.
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http://dx.doi.org/10.1016/j.jpeds.2017.10.027 | DOI Listing |
Knee Surg Sports Traumatol Arthrosc
December 2024
Sporthopaedicum, Berlin, Germany.
Purpose: Sulcus-deepening trochleoplasty (TP) effectively treats patellofemoral (PF) instability (PFI) caused by high-grade trochlear dysplasia (TD), but current evidence is based on small case series. We hypothesised, that TP would result in significant functional improvements and a low re-dislocation rate but would not accelerate the progression of PF cartilage deterioration.
Methods: We retrospectively reviewed all TP cases performed by a single surgeon between 2015 and 2021.
Intern Med J
December 2024
Department of Interventional Neuroradiology, Austin Health, Melbourne, Victoria, Australia.
Enhancing patient comprehension of their health is crucial in improving health outcomes. The integration of artificial intelligence (AI) in distilling medical information into a conversational, legible format can potentially enhance health literacy. This review aims to examine the accuracy, reliability, comprehensiveness and readability of medical patient education materials (PEMs) simplified by AI models.
View Article and Find Full Text PDFOchsner J
January 2024
Department of Otolaryngology - Head and Neck Surgery, Tulane University, New Orleans, LA.
Patients and providers vary in how they describe common otolaryngology-related complaints. These differences can lead to miscommunication and frustration that may affect patient outcomes and satisfaction. The aim of this cross-sectional survey-based study was to explore the differences in migraine symptom selection by otolaryngology patients and clinicians.
View Article and Find Full Text PDFFront Public Health
December 2024
Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, MN, United States.
Objective: Individuals with Limited English Proficiency (LEP), including Spanish-preferred patients, face healthcare challenges due to language barriers. Despite the potential of digital health technologies to improve access and outcomes, there is a "digital divide" with underutilization among vulnerable populations, including Spanish-speaking LEP individuals, highlighting a need for increased understanding and equitable digital health solutions.
Materials And Methods: A multi-mode, multi-language cross-sectional survey was built based on the Technology Acceptance Model and deployed from a multi-state healthcare practice.
Front Med (Lausanne)
December 2024
Facultad de Ciencias de la Salud, Universidad Internacional de Valencia, Valencia, Spain.
Background And Purpose: Psoriasis is a chronic, immune-mediated inflammatory skin disease that significantly impacts patients' quality of life. The integration of telepharmacy has the potential to enhance patient care by providing flexible and personalized pharmaceutical follow-up. This study (TELEPROM Psoriasis) evaluates a telepharmacy model for evaluating electronic Patient-Reported outcomes (ePROMs) for individuals with moderate to severe plaque psoriasis in Spain with biological treatment.
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