Original researchAssessment of vulvovaginal complaints: accuracy of telephone triage and in-office diagnosis1☆,
Section snippets
Materials and methods
From June 1996 to August 1996, any female patient who called the Kaiser Permanente Phone Call Center with vulvovaginal complaints was referred to a registered nurse present in the Call Center for phone evaluation. This time frame was used to obtain a sample size of 500 patients, which was estimated to be sufficient for yielding reliable estimates of interrater agreement. Using consecutive sampling, phone assessments of 485 women were obtained during this period. Exclusion criteria included
Results
A total of 485 patients underwent telephone evaluation and were appointed to see a physician, nurse midwife, or physician’s assistant. Office staff relied on the Call Center to alert them to a patient who had been evaluated by phone by indicating “Vaginitis Study Patient” in the appointment comments. However, because of busy schedules and other distractions, Call Center nurses recorded this information intermittently. Hence, this comment was entered for only 253 (52%) of the 485 patients; these
Discussion
Most studies evaluating telephone triage systems have examined patient and practitioner satisfaction, that is, service parameters. Few studies have looked at outcomes or have prospectively attempted to answer questions of accuracy. This study prospectively evaluated accuracy and outcomes of phone management of vulvovaginal complaints, a common problem in gynecologic and primary care practices. The results show that telephone assessment of vulvovaginal complaints is poor, and as such, telephone
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Cited by (0)
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This work was supported by a Research & Development grant from Kaiser Permanente, Colorado.
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We thank James McGregor, MD, for his assistance in this study.