Digital Consultations: A Questionable Path for Tonsillitis Diagnosis

Digital healthcare consultations are insufficient for safely assessing tonsillitis. The lack of reliability may lead to the risk of over- or undertreatment of sore throats (1^✔ ✔Trusted Source
Inter-rater reliability of Centor score assessments between telemedicine and in-person examinations in patients with an acute sore throat

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What is Tonsillitis

Tonsillitis is a common reason for visits to the doctor and prescriptions of antibiotics in primary care. To determine whether a patient needs antibiotics, doctors use the so-called Centor Criteria for tonsillitis. The criteria include fever, tender and swollen lymph nodes in the angles of the jaw and inspection of the tonsils.

However, it has been unclear how well these criteria can be assessed during digital healthcare consultations compared to traditional in-person consultations. This lack of scientific evidence has become a growing concern as digital healthcare consultations become more common.

The current study, published in the journal Infectious Diseases, examines whether digital assessments are as reliable as physical examinations in determining whether antibiotic treatment is warranted. The study includes 189 patients who sought care at healthcare clinics and urgent care clinics in Region Västra Götaland, Sweden, between January 2020 and October 2023.

Each patient in the study underwent two assessments: a digital medical assessment via video and a physical examination conducted by another doctor. The results show that digital healthcare consultations are not sufficient to assess some of the most important criteria, such as tonsil inspection and lymph node examination.

One of the driving forces behind the study is Patrycja Woldan-Gradalska, a PhD student at Sahlgrenska Academy at the University of Gothenburg and a Resident Physician at Sätila Healthcare Clinic.

The authors are active in community medicine and public health at Sahlgrenska Academy at the University of Gothenburg and at Region Västra Götaland's FoUUI primary and community healthcare, a support resource for research, education, development and innovation.

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Reference:

1. Inter-rater reliability of Centor score assessments between telemedicine and in-person examinations in patients with an acute sore throat - (https://www.tandfonline.com/doi/full/10.1080/23744235.2024.2434878)

Source-Eurekalert