Evidence map›Paper›PMID 33436454›Full record

ArticleCMAJ open

A comparison of faxed referrals and eConsult questions for rheumatology referrals: a descriptive study.

Erin Keely, Krista Rostom, Douglas Smith, Clare Liddy

Abstract readComparative Study
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Management of Rheumatoid Arthritis in Primary Care: A Scoping Review.International journal of environmental research and public health · 2024
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Erin KeelyDepartment of Medicine (Keely, Smith), University of Ottawa; Department of Medicine (Keely, Smith) and Ontario eConsult Centre of Excellence (Keely, Liddy), The Ottawa Hospital; Department of Medicine (Rostom), Queensway Carleton Hospital; Department of Family Medicine (Liddy), C.T. Lamont Primary Health Care Research Centre, University of Ottawa; Bruyère Research Institute (Liddy), Ottawa, Ont. ekeely@toh.ca.
Krista RostomDepartment of Medicine (Keely, Smith), University of Ottawa; Department of Medicine (Keely, Smith) and Ontario eConsult Centre of Excellence (Keely, Liddy), The Ottawa Hospital; Department of Medicine (Rostom), Queensway Carleton Hospital; Department of Family Medicine (Liddy), C.T. Lamont Primary Health Care Research Centre, University of Ottawa; Bruyère Research Institute (Liddy), Ottawa, Ont.
Douglas SmithDepartment of Medicine (Keely, Smith), University of Ottawa; Department of Medicine (Keely, Smith) and Ontario eConsult Centre of Excellence (Keely, Liddy), The Ottawa Hospital; Department of Medicine (Rostom), Queensway Carleton Hospital; Department of Family Medicine (Liddy), C.T. Lamont Primary Health Care Research Centre, University of Ottawa; Bruyère Research Institute (Liddy), Ottawa, Ont.
Clare LiddyDepartment of Medicine (Keely, Smith), University of Ottawa; Department of Medicine (Keely, Smith) and Ontario eConsult Centre of Excellence (Keely, Liddy), The Ottawa Hospital; Department of Medicine (Rostom), Queensway Carleton Hospital; Department of Family Medicine (Liddy), C.T. Lamont Primary Health Care Research Centre, University of Ottawa; Bruyère Research Institute (Liddy), Ottawa, Ont.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Canada, wait times for access to specialized rheumatology services have increased, leading to new strategies to improve timely care; electronic consultations (eConsults) enable providers to ask specialists a clinical question using a secure platform, often reducing the need for a face-to-face visit. In this study, we sought to compare the types of referrals received through fax versus eConsult and to determine whether faxed referrals could be addressed using eConsult.

methodsWe conducted a descriptive study of consecutive faxed referrals sent to a tertiary care centre between Feb. 1 and Mar. 6, 2017, and a convenience sample of eConsults directed to rheumatology between Feb. 1, 2015, and Sept. 30, 2016, through the Champlain BASE eConsult Service, an Ontario-based service. We reviewed all referrals and categorized them by clinical content and question type. A rheumatologist with experience completing eConsult referrals assessed faxed referrals for their suitability to be answered through eConsults. Descriptive statistics were generated.

resultsWe analyzed 300 consecutive faxed referrals and 300 (of 470) eConsult referrals. Faxed questions more often pertained to rheumatoid arthritis (32/300 [10.7%] v. 17/300 [5.7%]), systemic lupus erythematosus (24/300 [8.0%] v. 10/300 [3.3%]), and polyarthritis (30/300 [10.0%] v. 18/300 [6.0%]). eConsults more often addressed abnormal serology without joint symptoms (27/300 [9.0%] v. 8/300 [2.7%]) and gout (15/300 [5.0%] v. 4/300 [1.3%]). Faxed referrals were more likely to have no specific question (116/300 [38.7%]), and eConsults were more likely to have more than 1 question posed (99/300 [33.0%]) and a drug-related question (67/300 [22.3%]). The rheumatologist identified potential benefit from eConsult in 216/300 (72.0%) faxed referrals and 55/59 (93.2%) declined faxed referrals.

interpretationDespite differences in diagnosis between eConsults and faxed referrals, most faxed referrals showed the potential to be addressed through eConsult. Using eConsult may allow primary care providers to obtain answers to questions without requesting a face-to-face specialist referral, or provide support for patients awaiting face-to-face consultation.

Indexed as

Remote ConsultationRheumatologyTelefacsimileAdultAgedArthritisArthritis, RheumatoidFemaleHumansLupus Erythematosus, SystemicMaleMiddle AgedReferral and ConsultationTertiary Care Centers

Identifiers

PMID33436454
PMCPMC7843073

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Registered trials

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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.