Exploratory study: use of OSCEs in teleconsultation to evaluate diagnostic hypotheses provided by a symptom checker

Abstract

Abstract Backround: The overloading of health care systems is an international problem. In this context, new tools such as symptom checker (SC) are emerging to improve patient orientation and triage. Similarly, the COVID-19 pandemic saw the emergence of teleconsultations. The OSCEs could be adapted in this sense for evaluation and training purposes.Objective: The main objective of this study was to explore the performance of a symptom checker against emergency physicians using OSCEs as an assessment method.Methods: We explored a method to evaluate a SC and physician with simulation. A panel of medical experts wrote 220 simulated patients. Each situation was played twice by an actor trained to the role, once in front of the SC, once in front of a physician. Like a telephone consultation, only the patient's voice was accessible. We performed a prospective diagnostic non-inferiority study. If primary analysis failed to detect non-inferiority, we have planned a superiority analysisResults: We cannot conclude if the SC is non-inferior. However, the emergency physician was superior compared to the SC in terms of principal diagnosis (81% versus 30%) and association of principal and secondary diagnosis (92% versus 52%). In terms of patient triage (vital emergency or not), there is still a medical superiority (96% versus 71%). There is also a non-inferiority of the SC compared to the physician in terms of interviewing time.Conclusions and relevance: This type of evaluation should be extended to other types of software in order to provide scientific evidence of the application of tools used in pedagogy to a more clinical research, but also to deepen the evaluation for educational purposes in the face of the advent of physician 2.0.

Ähnliche Arbeiten