Trial reportBMJ (Clinical research ed.)2003
Virtual outreach: economic evaluation of joint teleconsultations for patients referred by their general practitioner for a specialist opinion.
Trial report in BMJ (Clinical research ed.), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Interactive telemedicine: effects on professional practice and health care outcomes.The Cochrane database of systematic reviews · 2015Pooled it
- A systematic review of economic analyses of telehealth services using real time video communication.BMC health services research · 2010Pooled it
- Cost-Effectiveness of Telemedicine in Remote Orthopedic Consultations: Randomized Controlled Trial.Journal of medical Internet research · 2019Trial
- Acceptability, Feasibility, and Cost of Telemedicine for Nonacute Headaches: A Randomized Study Comparing Video and Traditional Consultations.Journal of medical Internet research · 2016Trial
- Are patients satisfied with a web-based followup after total joint arthroplasty?Clinical orthopaedics and related research · 2014Trial
- Validation of Virtual Wrist Range of Motion Measurements Using Video Coaching.Journal of hand surgery global online · 2025Article
- The financial impact and utilization of inpatient dermatology services: historical insights and future implications.Archives of dermatological research · 2025Review
- Article
- Post-COVID-19: can digital solutions lead to a more equitable global healthcare workforce?BJPsych international · 2023Article
- Reliability of a human pose tracking algorithm for measuring upper limb joints: comparison with photography-based goniometry.BMC musculoskeletal disorders · 2022Article
- Primary care consultations for respiratory tract symptoms during the COVID-19 pandemic: a cohort study including 70,000 people in South West England.Family practice · 2022Article
- Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown-Individual Observation.International journal of environmental research and public health · 2022Article
- Pilot trial of telemedicine in urology: Video vs. telephone consultations.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2022Article
- Good Comes From Evil: COVID-19 and the Advent of Telemedicine in Orthopedics.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2021Article
- Opportunity costs of attending surgical clinic appointments and experiences with telemedicine for follow-up care.SAGE open medicine · 2021Article
- COVID-19 and beyond: virtual consultations in primary care-reflecting on the evidence base for implementation and ensuring reach: commentary article.BMJ health & care informatics · 2021Article
- Implementing video visits into an orthopedic hip arthroscopy practice: a case study.Journal of hip preservation surgery · 2020Article
- The Use of Patient-Facing Teleconsultations in the National Health Service: Scoping Review.JMIR medical informatics · 2020Article
- Electronic Consultation in Primary Care Between Providers and Patients: Systematic Review.JMIR medical informatics · 2019Review
- Patient preferences on the use of technology in cancer surveillance after curative surgery: A cross-sectional analysis.Surgery · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo test the hypotheses that, compared with conventional outpatient consultations, joint teleconsultation (virtual outreach) would incur no increased costs to the NHS, reduce costs to patients, and reduce absences from work by patients and their carers.
designCost consequences study alongside randomised controlled trial.
settingTwo hospitals in London and Shrewsbury and 29 general practices in inner London and Wales.
participants3170 patients identified; 2094 eligible for inclusion and willing to participate. 1051 randomised to virtual outreach and 1043 to standard outpatient appointments.
main outcome measuresNHS costs, patient costs, health status (SF-12), time spent attending index consultation, patient satisfaction.
resultsOverall six months costs were greater for the virtual outreach consultations ( pound 724 per patient) than for conventional outpatient appointments ( pound 625): difference in means pound 99 ($162; 138) (95% confidence interval pound 10 to pound 187, P=0.03). If the analysis is restricted to resource items deemed "attributable" to the index consultation, six month costs were still greater for virtual outreach: difference in means pound 108 ( pound 73 to pound 142, P < 0.0001). In both analyses the index consultation accounted for the excess cost. Savings to patients in terms of costs and time occurred in both centres: difference in mean total patient cost pound 8 ( pound 5 to pound 10, P < 0.0001). Loss of productive time was less in the virtual outreach group: difference in mean cost pound 11 ( pound 10 to pound 12, P < 0.0001).
conclusionThe main hypothesis that virtual outreach would be cost neutral is rejected, but the hypotheses that costs to patients and losses in productivity would be lower are supported.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.