Telemedicine in a spine clinic setting: a large survey of patient preferences and experiences.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has greatly disturbed healthcare and the practice of neurosurgery. As healthcare systems evolve in the face of COVID-19, the use of telehealth platforms has expanded. We presented the results of a large survey of patient perspectives on the role of telehealth in the care of spine clinic patients. METHODS: All patients at the spine clinic of a large, tertiary, academic medical center were surveyed at their clinic visit from May 30, 2020-June 30, 2020. All responses were anonymous, and results were analyzed with standard statistical techniques. RESULTS: One hundred and seventy-six surveys were returned and 164 were entirely completed. 56.8% of patients were new while 24.4% were postoperative follow-up visits: 54.9% had lumbar symptoms. 85% had pain while more than half also reported weakness; 58% traveled greater than twenty-five miles for their appointment; 96% had transportation readily available. Of all respondents, only 15.3% preferred the appointment via video telehealth while 4% had no preference between in-person appointment or virtual visit. Preference for telehealth appointment was not associated with factors such as new or established in the practice, spinal region of symptoms, pain, weakness, comfort with technology, age, or duration of symptoms. There was a significant difference between how far the patient traveled for the clinic appointment and their preference for a telehealth appointment, with patients traveling further distances favoring telehealth (P=0.04). This effect remained significant when stratifying based on 25 miles (P=0.03) or 50 miles (P=0.03) but not when stratifying based on 100 miles (P=0.32). However, the sample size of patients traveling >100 miles was small, limiting any inference regarding that subgroup. Access to transportation was associated with preference for telehealth (88.89% vs. 97.18%, P=0.08) but did not reach statistical significance. CONCLUSIONS: Most spine patients prefer in-person clinic appointments to virtual appointments. These preferences should be considered when arranging patient encounters.

Distal Biceps Tendon Rupture Videos on YouTube: An Analysis of Video Content and Quality.

Purpose: Our purpose was to analyze the content and quality of YouTube videos related to distal biceps tendon (DBT) ruptures and repair. We aimed to compare differences between academic and nonacademic video sources. Methods: The most popular YouTube videos related to DBT injuries were compiled and analyzed according to source. Viewing characteristics were determined for each video. Video content and quality were assessed by 2 reviewers and analyzed according to the Journal of the American Medical Association benchmark criteria, DISCERN criteria, and a Distal Biceps Content Score. Cohen's kappa was used to measure interrater reliability. Results: A total of 59 DBT YouTube videos were included. The intraclass correlation coefficients ranged from moderate to excellent for the content scores. The mean DISCERN score was 29, and no videos were rated as either "good" or "excellent" for content quality. With the exception of the mean Journal of the American Medical Association criteria score (1.5 vs 0.5), videos from academic sources did not demonstrate significantly higher levels of content quality. Only 4/59 videos (7%) discussed the natural history of nonsurgically treated DBT ruptures. Of the 32 videos that discussed surgical techniques, only 3/32 (9%) had a preference for 2-incision techniques. No videos discussed the association between spontaneous DBT ruptures and cardiac amyloidosis. Conclusions: The overall content, quality, and reliability of DBT videos on YouTube are poor. Videos from academic sources do not provide higher-quality information than videos from nonacademic sources. Videos related to operative treatment of DBT ruptures more frequently discuss single-incision techniques. Clinical relevance: Social media videos can function as direct-to-consumer marketing materials, and surgeons should be prepared to address misconceptions regarding the management of DBT tears. Patients are increasingly seeking health information online, and surgeons should direct patients toward more reliable and vetted sources of information.