1. E-consensus on telemedicine in proctology: A RAND/UCLA-modified study
- Author
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Gaetano Gallo, Ugo Grossi, Alessandro Sturiale, Gian Luca Di Tanna, Arcangelo Picciariello, Sergio Pillon, Domenico Mascagni, Donato Francesco Altomare, Gabriele Naldini, Roberto Perinotti, Corrado Bottini, Salvatore Bracchitta, Luigi Brusciano, Filippo Caminati, Francesco Cantarella, Valerio Celentano, Gianpiero Cione Paola De Nardi, Francesco Ferrara, Cristina Folliero, Paolo Giamundo, Iacopo Giani, Ivana Giannini, Maria Carmela Giuffrida, Aldo Infantino, Marco La Torre, Andrea Lauretta, Giorgio Lisi, Luigi Losacco, Anna Maffioli, Stefano Mancini, Fabio Marino, Jacopo Martellucci, Piercarlo Meinero, Giovanni Milito, Massimiliano Mistrangelo, Lorenzo Mori, Simone Orlandi, Francesco Pata, Beatrice Pessia, Renato Pietroletti, Mauro Pozzo, Filippo Pucciani, Carlo Ratto, Lucia Romano, Maurizio Roveroni, Giulio Santoro, Alberto Serventi, Davide Telesco, Alessandro Testa, Paolo Tonello, Nicola Tricomi, Mario Trompetto, Roberta Tutino, Gloria Zaffaroni, Julio Mayol, Gallo, Gaetano, Grossi, Ugo, Sturiale, Alessandro, Di Tanna, Gian Luca, Picciariello, Arcangelo, Pillon, Sergio, Mascagni, Domenico, Altomare, Donato Francesco, Naldini, Gabriele, Perinotti, Roberto, Bottini, Corrado, Bracchitta, Salvatore, Brusciano, Luigi, Caminati, Filippo, Cantarella, Francesco, Celentano, Valerio, Paola De Nardi, Gianpiero Cione, Ferrara, Francesco, Folliero, Cristina, Giamundo, Paolo, Giani, Iacopo, Giannini, Ivana, Giuffrida, Maria Carmela, Infantino, Aldo, La Torre, Marco, Lauretta, Andrea, Lisi, Giorgio, Losacco, Luigi, Maffioli, Anna, Mancini, Stefano, Marino, Fabio, Martellucci, Jacopo, Meinero, Piercarlo, Milito, Giovanni, Mistrangelo, Massimiliano, Mori, Lorenzo, Orlandi, Simone, Pata, Francesco, Pessia, Beatrice, Pietroletti, Renato, Pozzo, Mauro, Pucciani, Filippo, Ratto, Carlo, Romano, Lucia, Roveroni, Maurizio, Santoro, Giulio, Serventi, Alberto, Telesco, Davide, Testa, Alessandro, Tonello, Paolo, Tricomi, Nicola, Trompetto, Mario, Tutino, Roberta, Zaffaroni, Gloria, and Mayol, Julio
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Male ,medicine.medical_specialty ,Telemedicine ,Coronavirus disease 2019 (COVID-19) ,Settore MED/18 - CHIRURGIA GENERALE ,e-consensus ,MEDLINE ,030230 surgery ,proctology ,Pelvic Floor Disorders ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,medicine ,Humans ,Medical prescription ,Anal fissure ,telemedicine ,business.industry ,Colorectal Surgery ,Female ,Middle Aged ,medicine.disease ,Colorectal surgery ,030220 oncology & carcinogenesis ,Family medicine ,Surgery ,business ,telemedicina - Abstract
Background Coronavirus disease 2019 is revolutionizing healthcare delivery. The aim of this study was to reach a consensus among experts as to the possible applications of telemedicine in the proctologic field. Methods A group of 55 clinical practice recommendations was developed by a clinical guidance group based on coalescence of evidence and expert opinion. The Telemedicine in Proctology Italian Working Group included 47 Italian Society of Colorectal Surgery nominated experts evaluating the appropriateness of each clinical practice recommendations based on published RAND/UCLA methodology in 2 rounds. Results Stakeholder median age was 53 years (interquartile range limits 40–60), and 38 (81%) were men. Nine (19%) panelists reported no experience with telemedicine before the pandemic. Agreement was obtained on a minimum of 3 to 5 years of practice in the proctologic field before starting teleconsultations, which should be regularly paid, with advice and prescriptions incorporated into a formal report sent to the patient by e-mail along with a receipt. Of the panelists, 35 of 47 (74%) agreed that teleconsultation carries the risk of misdiagnosis of cancer, thus recommending an in-person assessment before scheduling any surgery. Fifteen additional clinical practice recommendations were re-elaborated in the second round and assessed by 44 of 47 (93.6%) panelists. The application of telemedicine for the diagnosis of common proctologic conditions (eg, hemorrhoidal disease, anal abscess and fistula, anal condylomas, and anal fissure) and functional pelvic floor disorders was generally considered inappropriate. Teleconsultation was instead deemed appropriate for the diagnosis and management of pilonidal disease. Conclusion This e-consensus revealed the boundaries of telemedicine in Italy. Standardization of infrastructures, logistics, and legality remain to be better elucidated.
- Published
- 2021
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