E-consensus on telemedicine in proctology: A RAND/UCLA-modified study

Gaetano Gallo; Ugo Grossi; Alessandro Sturiale; Gian Luca Di Tanna; Arcangelo Picciariello; Sergio Pillon; Domenico Mascagni; Donato Francesco Altomare; Gabriele Naldini; Roberto Perinotti; Corrado Bottini; Salvatore Bracchitta; Luigi Brusciano; Filippo Caminati; Francesco Cantarella; Valerio Celentano; Gianpiero Cione Paola De Nardi; Francesco Ferrara; Cristina Folliero; Paolo Giamundo; Iacopo Giani; Ivana Giannini; Maria Carmela Giuffrida; Aldo Infantino; Marco La Torre; Andrea Lauretta; Giorgio Lisi; Luigi Losacco; Anna Maffioli; Stefano Mancini; Fabio Marino; Jacopo Martellucci; Piercarlo Meinero; Giovanni Milito; Massimiliano Mistrangelo; Lorenzo Mori; Simone Orlandi; Francesco Pata; Beatrice Pessia; Renato Pietroletti; Mauro Pozzo; Filippo Pucciani; Carlo Ratto; Lucia Romano; Maurizio Roveroni; Giulio Santoro; Alberto Serventi; Davide Telesco; Alessandro Testa; Paolo Tonello; Nicola Tricomi; Mario Trompetto; Roberta Tutino; Gloria Zaffaroni; Julio Mayol

doi:10.1016/j.surg.2021.01.049

E-consensus on telemedicine in proctology: A RAND/UCLA-modified study

Gaetano Gallo, Ugo Grossi, Alessandro Sturiale, Gian Luca Di Tanna, Arcangelo Picciariello, Sergio Pillon, Domenico Mascagni, Donato Francesco Altomare, Gabriele Naldini, Roberto Perinotti, Corrado Bottini, Salvatore Bracchitta, Luigi Brusciano, Filippo Caminati, Francesco Cantarella, Valerio Celentano, Gianpiero Cione Paola De Nardi, Francesco Ferrara, Cristina Folliero, Paolo GiamundoIacopo Giani, Ivana Giannini, Maria Carmela Giuffrida, Aldo Infantino, Marco La Torre, Andrea Lauretta, Giorgio Lisi, Luigi Losacco, Anna Maffioli, Stefano Mancini, Fabio Marino, Jacopo Martellucci, Piercarlo Meinero, Giovanni Milito, Massimiliano Mistrangelo, Lorenzo Mori, Simone Orlandi, Francesco Pata, Beatrice Pessia, Renato Pietroletti, Mauro Pozzo, Filippo Pucciani, Carlo Ratto, Lucia Romano, Maurizio Roveroni, Giulio Santoro, Alberto Serventi, Davide Telesco, Alessandro Testa, Paolo Tonello, Nicola Tricomi, Mario Trompetto, Roberta Tutino, Gloria Zaffaroni, Julio Mayol

Research output: Contribution to journal › Article

Abstract

Background: Coronavirus disease 2019 is revolutionizing healthcare delivery. The aim of this study was to reach a consensus among experts as to the possible applications of telemedicine in the proctologic field. Methods: A group of 55 clinical practice recommendations was developed by a clinical guidance group based on coalescence of evidence and expert opinion. The Telemedicine in Proctology Italian Working Group included 47 Italian Society of Colorectal Surgery nominated experts evaluating the appropriateness of each clinical practice recommendations based on published RAND/UCLA methodology in 2 rounds. Results: Stakeholder median age was 53 years (interquartile range limits 40–60), and 38 (81%) were men. Nine (19%) panelists reported no experience with telemedicine before the pandemic. Agreement was obtained on a minimum of 3 to 5 years of practice in the proctologic field before starting teleconsultations, which should be regularly paid, with advice and prescriptions incorporated into a formal report sent to the patient by e-mail along with a receipt. Of the panelists, 35 of 47 (74%) agreed that teleconsultation carries the risk of misdiagnosis of cancer, thus recommending an in-person assessment before scheduling any surgery. Fifteen additional clinical practice recommendations were re-elaborated in the second round and assessed by 44 of 47 (93.6%) panelists. The application of telemedicine for the diagnosis of common proctologic conditions (eg, hemorrhoidal disease, anal abscess and fistula, anal condylomas, and anal fissure) and functional pelvic floor disorders was generally considered inappropriate. Teleconsultation was instead deemed appropriate for the diagnosis and management of pilonidal disease. Conclusion: This e-consensus revealed the boundaries of telemedicine in Italy. Standardization of infrastructures, logistics, and legality remain to be better elucidated.

Original language	English
Pages (from-to)	1-10
Number of pages	10
Journal	Surgery
DOIs	https://doi.org/10.1016/j.surg.2021.01.049
Publication status	Published - 2021

Keywords

telemedicina

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.surg.2021.01.049

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Gallo, G., Grossi, U., Sturiale, A., Di Tanna, G. L., Picciariello, A., Pillon, S., Mascagni, D., Altomare, D. F., Naldini, G., Perinotti, R., Bottini, C., Bracchitta, S., Brusciano, L., Caminati, F., Cantarella, F., Celentano, V., Paola De Nardi, G. C., Ferrara, F., Folliero, C., ... Mayol, J. (2021). E-consensus on telemedicine in proctology: A RAND/UCLA-modified study. Surgery, 1-10. https://doi.org/10.1016/j.surg.2021.01.049

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title = "E-consensus on telemedicine in proctology: A RAND/UCLA-modified study",

abstract = "Background: Coronavirus disease 2019 is revolutionizing healthcare delivery. The aim of this study was to reach a consensus among experts as to the possible applications of telemedicine in the proctologic field. Methods: A group of 55 clinical practice recommendations was developed by a clinical guidance group based on coalescence of evidence and expert opinion. The Telemedicine in Proctology Italian Working Group included 47 Italian Society of Colorectal Surgery nominated experts evaluating the appropriateness of each clinical practice recommendations based on published RAND/UCLA methodology in 2 rounds. Results: Stakeholder median age was 53 years (interquartile range limits 40–60), and 38 (81%) were men. Nine (19%) panelists reported no experience with telemedicine before the pandemic. Agreement was obtained on a minimum of 3 to 5 years of practice in the proctologic field before starting teleconsultations, which should be regularly paid, with advice and prescriptions incorporated into a formal report sent to the patient by e-mail along with a receipt. Of the panelists, 35 of 47 (74%) agreed that teleconsultation carries the risk of misdiagnosis of cancer, thus recommending an in-person assessment before scheduling any surgery. Fifteen additional clinical practice recommendations were re-elaborated in the second round and assessed by 44 of 47 (93.6%) panelists. The application of telemedicine for the diagnosis of common proctologic conditions (eg, hemorrhoidal disease, anal abscess and fistula, anal condylomas, and anal fissure) and functional pelvic floor disorders was generally considered inappropriate. Teleconsultation was instead deemed appropriate for the diagnosis and management of pilonidal disease. Conclusion: This e-consensus revealed the boundaries of telemedicine in Italy. Standardization of infrastructures, logistics, and legality remain to be better elucidated.",

keywords = "telemedicina, telemedicina",

author = "Gaetano Gallo and Ugo Grossi and Alessandro Sturiale and {Di Tanna}, {Gian Luca} and Arcangelo Picciariello and Sergio Pillon and Domenico Mascagni and Altomare, {Donato Francesco} and Gabriele Naldini and Roberto Perinotti and Corrado Bottini and Salvatore Bracchitta and Luigi Brusciano and Filippo Caminati and Francesco Cantarella and Valerio Celentano and {Paola De Nardi}, {Gianpiero Cione} and Francesco Ferrara and Cristina Folliero and Paolo Giamundo and Iacopo Giani and Ivana Giannini and Giuffrida, {Maria Carmela} and Aldo Infantino and {La Torre}, Marco and Andrea Lauretta and Giorgio Lisi and Luigi Losacco and Anna Maffioli and Stefano Mancini and Fabio Marino and Jacopo Martellucci and Piercarlo Meinero and Giovanni Milito and Massimiliano Mistrangelo and Lorenzo Mori and Simone Orlandi and Francesco Pata and Beatrice Pessia and Renato Pietroletti and Mauro Pozzo and Filippo Pucciani and Carlo Ratto and Lucia Romano and Maurizio Roveroni and Giulio Santoro and Alberto Serventi and Davide Telesco and Alessandro Testa and Paolo Tonello and Nicola Tricomi and Mario Trompetto and Roberta Tutino and Gloria Zaffaroni and Julio Mayol",

year = "2021",

doi = "10.1016/j.surg.2021.01.049",

language = "English",

pages = "1--10",

journal = "Surgery",

issn = "0039-6060",

publisher = "Elsevier Inc.",

}

Gallo, G, Grossi, U, Sturiale, A, Di Tanna, GL, Picciariello, A, Pillon, S, Mascagni, D, Altomare, DF, Naldini, G, Perinotti, R, Bottini, C, Bracchitta, S, Brusciano, L, Caminati, F, Cantarella, F, Celentano, V, Paola De Nardi, GC, Ferrara, F, Folliero, C, Giamundo, P, Giani, I, Giannini, I, Giuffrida, MC, Infantino, A, La Torre, M, Lauretta, A, Lisi, G, Losacco, L, Maffioli, A, Mancini, S, Marino, F, Martellucci, J, Meinero, P, Milito, G, Mistrangelo, M, Mori, L, Orlandi, S, Pata, F, Pessia, B, Pietroletti, R, Pozzo, M, Pucciani, F, Ratto, C, Romano, L, Roveroni, M, Santoro, G, Serventi, A, Telesco, D, Testa, A, Tonello, P, Tricomi, N, Trompetto, M, Tutino, R, Zaffaroni, G & Mayol, J 2021, 'E-consensus on telemedicine in proctology: A RAND/UCLA-modified study', Surgery, pp. 1-10. https://doi.org/10.1016/j.surg.2021.01.049

TY - JOUR

T1 - E-consensus on telemedicine in proctology: A RAND/UCLA-modified study

AU - Gallo, Gaetano

AU - Grossi, Ugo

AU - Sturiale, Alessandro

AU - Di Tanna, Gian Luca

AU - Picciariello, Arcangelo

AU - Pillon, Sergio

AU - Mascagni, Domenico

AU - Altomare, Donato Francesco

AU - Naldini, Gabriele

AU - Perinotti, Roberto

AU - Bottini, Corrado

AU - Bracchitta, Salvatore

AU - Brusciano, Luigi

AU - Caminati, Filippo

AU - Cantarella, Francesco

AU - Celentano, Valerio

AU - Paola De Nardi, Gianpiero Cione

AU - Ferrara, Francesco

AU - Folliero, Cristina

AU - Giamundo, Paolo

AU - Giani, Iacopo

AU - Giannini, Ivana

AU - Giuffrida, Maria Carmela

AU - Infantino, Aldo

AU - La Torre, Marco

AU - Lauretta, Andrea

AU - Lisi, Giorgio

AU - Losacco, Luigi

AU - Maffioli, Anna

AU - Mancini, Stefano

AU - Marino, Fabio

AU - Martellucci, Jacopo

AU - Meinero, Piercarlo

AU - Milito, Giovanni

AU - Mistrangelo, Massimiliano

AU - Mori, Lorenzo

AU - Orlandi, Simone

AU - Pata, Francesco

AU - Pessia, Beatrice

AU - Pietroletti, Renato

AU - Pozzo, Mauro

AU - Pucciani, Filippo

AU - Ratto, Carlo

AU - Romano, Lucia

AU - Roveroni, Maurizio

AU - Santoro, Giulio

AU - Serventi, Alberto

AU - Telesco, Davide

AU - Testa, Alessandro

AU - Tonello, Paolo

AU - Tricomi, Nicola

AU - Trompetto, Mario

AU - Tutino, Roberta

AU - Zaffaroni, Gloria

AU - Mayol, Julio

PY - 2021

Y1 - 2021

N2 - Background: Coronavirus disease 2019 is revolutionizing healthcare delivery. The aim of this study was to reach a consensus among experts as to the possible applications of telemedicine in the proctologic field. Methods: A group of 55 clinical practice recommendations was developed by a clinical guidance group based on coalescence of evidence and expert opinion. The Telemedicine in Proctology Italian Working Group included 47 Italian Society of Colorectal Surgery nominated experts evaluating the appropriateness of each clinical practice recommendations based on published RAND/UCLA methodology in 2 rounds. Results: Stakeholder median age was 53 years (interquartile range limits 40–60), and 38 (81%) were men. Nine (19%) panelists reported no experience with telemedicine before the pandemic. Agreement was obtained on a minimum of 3 to 5 years of practice in the proctologic field before starting teleconsultations, which should be regularly paid, with advice and prescriptions incorporated into a formal report sent to the patient by e-mail along with a receipt. Of the panelists, 35 of 47 (74%) agreed that teleconsultation carries the risk of misdiagnosis of cancer, thus recommending an in-person assessment before scheduling any surgery. Fifteen additional clinical practice recommendations were re-elaborated in the second round and assessed by 44 of 47 (93.6%) panelists. The application of telemedicine for the diagnosis of common proctologic conditions (eg, hemorrhoidal disease, anal abscess and fistula, anal condylomas, and anal fissure) and functional pelvic floor disorders was generally considered inappropriate. Teleconsultation was instead deemed appropriate for the diagnosis and management of pilonidal disease. Conclusion: This e-consensus revealed the boundaries of telemedicine in Italy. Standardization of infrastructures, logistics, and legality remain to be better elucidated.

AB - Background: Coronavirus disease 2019 is revolutionizing healthcare delivery. The aim of this study was to reach a consensus among experts as to the possible applications of telemedicine in the proctologic field. Methods: A group of 55 clinical practice recommendations was developed by a clinical guidance group based on coalescence of evidence and expert opinion. The Telemedicine in Proctology Italian Working Group included 47 Italian Society of Colorectal Surgery nominated experts evaluating the appropriateness of each clinical practice recommendations based on published RAND/UCLA methodology in 2 rounds. Results: Stakeholder median age was 53 years (interquartile range limits 40–60), and 38 (81%) were men. Nine (19%) panelists reported no experience with telemedicine before the pandemic. Agreement was obtained on a minimum of 3 to 5 years of practice in the proctologic field before starting teleconsultations, which should be regularly paid, with advice and prescriptions incorporated into a formal report sent to the patient by e-mail along with a receipt. Of the panelists, 35 of 47 (74%) agreed that teleconsultation carries the risk of misdiagnosis of cancer, thus recommending an in-person assessment before scheduling any surgery. Fifteen additional clinical practice recommendations were re-elaborated in the second round and assessed by 44 of 47 (93.6%) panelists. The application of telemedicine for the diagnosis of common proctologic conditions (eg, hemorrhoidal disease, anal abscess and fistula, anal condylomas, and anal fissure) and functional pelvic floor disorders was generally considered inappropriate. Teleconsultation was instead deemed appropriate for the diagnosis and management of pilonidal disease. Conclusion: This e-consensus revealed the boundaries of telemedicine in Italy. Standardization of infrastructures, logistics, and legality remain to be better elucidated.

KW - telemedicina

UR - http://hdl.handle.net/10807/181238

U2 - 10.1016/j.surg.2021.01.049

DO - 10.1016/j.surg.2021.01.049

M3 - Article

SN - 0039-6060

SP - 1

EP - 10

JO - Surgery

JF - Surgery

ER -

E-consensus on telemedicine in proctology: A RAND/UCLA-modified study

Abstract

Keywords

UN SDGs

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