Concordância interobservador e satisfação no uso da telemedicina para avaliação de lombalgia

Abstract

Telemedicine (TM) is a healthcare tool that facilitates access to specialized care, particularly in remote areas and for individuals with limited mobility, eliminating geographical barriers to healthcare and experiencing recent growth driven by the COVID-19 (SARS-CoV-2) pandemic. Its safety, efficacy, user satisfaction, and costeffectiveness are well-established, likely perpetuating its application in routine healthcare services. However, the lack of interpersonal contact and difficulties in dealing with technological resources are recognize barriers, restricting widespread and sustained use. Systematizing the process could contribute to overcoming these challenges. The aim of this study was to evaluate the effectiveness of systematized TM for treating patients with lower back pain compared to in-person care (AP). This was a cross-sectional, primary, and analytical study. The sample included adults aged 18 to 75 with persistent lower back pain for more than six weeks seeking care at the institution for the first time. All participants underwent evaluations in two different scenarios: TM and AP. Assessments were conducted by orthopedic physicians with varying levels of expertise, including second and third-year orthopedic and traumatology residents, orthopedists specialized in areas other than the spine, and orthopedists with a focus on spinal issues. Diagnostic agreement between the two forms of care was assessed using the International Classification of Diseases – 10th edition. Additionally, the time required for consultations and the satisfaction of the involved professionals were examined. A total of 122 individuals participated in the study, with an average age of 47 years, and 66.4% were women. Professional agreement on the diagnosis was 79.5%. The average consultation time was shorter in TM than in AP (6.7 minutes, p<0.001). Professional satisfaction varied by category, and spine specialists, considered to have greater knowledge of the disease, showed higher satisfaction, reaching 100% for Domain 1 (related to medical history), 92.9% for Domain 2 (examining the patient), 92.3% for Domain 3 (transmitting information to the patient), and 89.3% for Domain 4 (treatment guidance). TM demonstrated moderate diagnostic agreement, providing a 30% faster consultation time compared to AP. Professional satisfaction varied by level of expertise, comparable to AP for spine specialists.