Telemedicine in SLE

Description

Background Telemedicine (TM) has become indispensable to rheumatology care. Accumulating evidence suggests its high acceptance, satisfaction, and feasibility. There is a paucity of data on TM in systemic lupus erythematosus (SLE). This study aimed to evaluate the accuracy of SLE virtual outcome measures by evaluating whether physician assessments of SLE disease activity (DA) obtained during TM visits are comparable with those from face-to-face (F2F) visits. Methods This was a longitudinal study of SLE patients with variable DA levels from four academic lupus centers. Each participant was evaluated by the same physician at two visits, using a TM interview followed by F2F evaluation. SLE DA measures and physician/participant feedback were completed. Agreement between TM and F2F measures was analyzed using paired t-test, intraclass correlation coefficient (ICC), and Bland-Altman method. Results 163 participants completed 308 visits. At V1, TM slightly underestimated DA compared to F2F, with a mean score difference (SD) of –0.306 (1.671) for SLEDAI, -0.141 (2.869) for BILAG, -2.184 (16.140) for LFA-REAL, and -0.975 (8.209) for PhGA. Differences at V2 tended to be smaller than at V1. ICC showed high agreement at V1 (r=0.86-1) and V2 (r=0.92–1). Bland-Altman plots showed a high level of agreement. Conclusions TM assessments showed a high level of agreement between TM and F2F DA assessments at both visits. Smaller mean score differences and greater agreement at V2 than at V1 may be due to improvement with TM practice over time. The study supports increased use of TM in lupus clinical care and research.

Institutions

• Columbia University

  New York, New York

Categories

Funders

• United States Department of Defense

  Government of the United States of America

  District of Columbia, Washington

Licence