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- Title
The clinical impact of bedside fiberoptic laryngoscopic recording on a tertiary consult service.
- Authors
Lozada, Kirkland N.; Morton, Kathryn; Stepan, Katelyn; Capo, Joseph; Chai, Raymond L.
- Abstract
<bold>Objectives/hypothesis: </bold>Fiberoptic laryngoscopy is dependent on accurate descriptions of examination findings. Traditional recording methods can be impractical for inpatient consults. Therefore, we aim to determine the utility of a smartphone-coupled portable recording system with flexible laryngoscopy for transmitting information between resident and attending physicians in a real-time setting.<bold>Study Design: </bold>Pilot prospective study in a tertiary academic hospital.<bold>Methods: </bold>This is a prospective study of inpatient consultations in a tertiary referral hospital over a 3-month period from April 2015 to June 2015. Flexible laryngoscopy was performed by a resident physician, and mobile recordings were relayed to an attending physician. Concordance of laryngoscopy interpretations between resident and attending physicians as well as changes in management were documented.<bold>Results: </bold>Seventy-nine fiberoptic examinations were recorded and compared. Each consult was categorized as follows: airway evaluation (AE) (43%, 34/79), voice evaluation (VE) (3.7%, 3/79), dysphagia (D) (24%, 19/79), and aerodigestive tract mass/pathology (ADM) (29.1%, 23/79). Nine examinations showed discordance between resident and attending interpretations. Inter-rater agreement was good, with a kappa value of 0.747 (95% confidence interval: 0.643-0.851). The frequency of discordant exams within each group was as follows: AE (15%, 5/34), VE (33%, 1/3), D (11%, 2/19), and ADM (4.3%, 1/23). In five patients, changes in laryngoscopy interpretation changed clinical management. Seven nondiscordant exams had a change in management after attending review. Of the 79 exams, only one required repeat flexible laryngoscopy by the attending physician.<bold>Conclusions: </bold>Portable recording of flexible laryngoscopy is an effective tool for timely management of inpatient consultations.<bold>Level Of Evidence: </bold>4. Laryngoscope, 128:818-822, 2018.
- Subjects
ENDOSCOPES; LARYNGOSCOPY; MEDICAL records; RECORDING instruments; TELEMEDICINE; VIDEO recording equipment; CONFIDENCE intervals; FIBER optics; LONGITUDINAL method; STATISTICS; SMARTPHONES; TERTIARY care
- Publication
Laryngoscope, 2018, Vol 128, Issue 4, p818
- ISSN
0023-852X
- Publication type
journal article
- DOI
10.1002/lary.26821