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Invited Commentary
August 20, 2020

The “New” PTAs—Practical Telehealth Applications

Author Affiliations
  • 1Department of Otorhinolaryngology–Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
JAMA Otolaryngol Head Neck Surg. 2020;146(10):914-915. doi:10.1001/jamaoto.2020.2284

The timely article by Mallen et al1 in this issue of JAMA Otolaryngology–Head & Neck Surgery is a practical application of telehealth to improve access to otolaryngology care. The goal of the study was to assess the reliability of telehealth in the diagnosis and triage of patients with suspected peritonsillar abscess (PTA). The authors tested the accuracy of PTA diagnosis by providing off-site otolaryngologists with a primary symptom and an oropharyngeal examination obtained using smartphone video documentation. They compared the predictions of these off-site otolaryngologists with objective evidence, such as needle aspiration or incision and drainage performed by otolaryngology house staff or findings on computed tomography scans, to determine diagnostic accuracy. This study showed that the remote clinicians could diagnose PTA with comparable accuracy (81%) using telehealth video examination, with minimal clinician variability. In the absence of an otolaryngologist, patients with PTAs often undergo computed tomography and experience prolonged emergency department visit wait times, hospital transfers and, occasionally, hospital admission. This study validates the use of telehealth consultation for one of the most common urgent consultations to otolaryngologists using widely available, low-cost, and easy-to-use technology.

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