Pilot Concordance Study to Evaluate the Accuracy of Teledentistry Compared to Direct Clinical Assessment for Diagnosis of Non-Emergent Soft Tissue Oral Pathologic Conditions in the Oral Medicine Graduate Clinic at the University of Alberta
Creators: Kandari, Ahammad
Publisher: name: University of Alberta Library
Year: 2023

<p>Background: Teledentistry uses telecommunication and information technologies to provide dental care remotely. This can include real-time consultations with a dentist or dental specialist and transmitting diagnostic information such as x-rays and images to other health care providers for consultation. Teledentistry has been used in various forms for several decades but has seen increased adoption recently due to technological advancements and the need for remote healthcare options. It is beneficial in rural areas where access to dental care can be limited and can help reduce costs and improve patient outcomes. It has been proposed that teledentistry can be used for various oral medicine needs such as diagnosis and treatment planning, patient education and monitoring, and follow-up care. Despite having existed since the 1990s, teledentistry was rapidly and widely adopted during the COVID-19 pandemic.</p>

<p>Objectives: This study aims to determine the accuracy and reliability of teledentistry for diagnosing non-emergent oral soft tissue lesions using conventional examination as a gold standard.</p>

<p>Methods:  Patients referred to the Oral Medicine Graduate Clinic at the University of Alberta and who have access to electronic devices, such as a computer, laptop, or tablet, were given the option to be entered into the study. Those who met the inclusion criteria and consented to participate in the study were contacted by a treatment coordinator who further discussed the next steps of both visits (virtual and in-person visits).</p>

<p>Results: We examined 48 participants in our study, and our study&#39;s results revealed a high degree of concordance between the virtual and in-person diagnoses of oral lesions made by the student. There was an almost perfect agreement when the instructors provided a diagnosis. During virtual and in-person patient visits, there was substantial agreement between the student and instructor regarding the diagnosis. There was evidence of homogeneity variances among intra- and inter-observer variability. This further supports the use of teledentistry to diagnose non-emergent soft tissue oral pathologic conditions. The results of the inter-method reliability between two students’ ratings (virtual vs clinical) were 0.951 - statistically significant. While the inter-method reliability results between two different instructors’ ratings (virtual vs clinical) were also 0.951 - statistically significant. On the other hand, the results of the inter-method reliability between the student and Instructor A ratings (virtual only) were 0.731 - substantial agreement, and the results of the inter-method reliability between the student and Instructor B ratings (clinical only) was 0.707 - statistically substantially significant. Patients were satisfied with both virtual and conventional examinations.  </p>

<p>Conclusions: According to the findings, teledentistry is potentially an accurate method for diagnosing non-emergent soft tissue oral pathologic conditions. It also provides graduate oral medicine students with adequate learning opportunities. In addition, patients were satisfied with both virtual and conventional examinations. The results obtained have been encouraging. However, additional prospective multicenter trials with many participants must confirm our findings.</p>