S956 Virtues of Virtual Care: A Randomized Sequential Trial of Appointment Styles for IBD Patients in Canada
Bibliographic record
Abstract
Introduction: COVID-19 spurred a dramatic shift from in-person patient visits toward virtual care. To date, there are no prospective studies randomizing patients to different styles of appointment and assessing their perspectives on the type of visit. We aimed to identify preferred styles of appointments across various patient factors to inform decisions regarding the optimal appointment style for patients. Methods: We randomized Inflammatory Bowel Disease (IBD) patients’ follow-up appointments to either in-person, video-assisted virtual, or via telephone and subsequent appointments to the alternate style of visit in a single-centre study in British Columbia, Canada. Participants completed surveys after each appointment style to minimize bias. We collected anthropometric data on participants and analyzed average scores assessing for potential associations. We used standard regression analyses and T-scores for assessment of statistical significance. Results: Eighty-six post-appointment surveys were completed, 30 in-person, 29 telephone, and 27 telehealth. We excluded 8 for incomplete data e.g. no appointment rating. The average age was 46.5 ±18yrs and 59% were female, 99% were follow-up appointments. The overall patient score by appointment type (out of ten) was 9.1 ±1.0 for in-person, 7.8 ±2.1 for telephone, and 8.0 ±2.6 for telehealth. The percentage of patients who would have preferred an alternate appointment style was 25.0% for in-person, 52.9% for telephone, and 33.0% for virtual. The highest rated factors for preference of an in-person appointment were optimal communication and interaction with care-provider (86.4%). Among participants who would have preferred telehealth appointments 62.5%, and 37.5% cited time savings and cost savings as reasons respectively, and 60.0% for the same reasons for telephone based appointments. In-person appointments were associated with a higher cost, longer time commitment. Neither age or gender were associated with any preferred style of appointment (Figure 1). Conclusion: In our study randomizing IBD patients to video-assisted virtual, telephone or in-person visits it is clear that all appointment styles have their merits. Despite the increased cost and time commitment, there was a trend toward preference of in-person appointments though there was no statistically significant difference. With the movement away from in-person patient visits we suggest than providers should consider patient preferences in choosing a style of appointment.Figure 1.: Patient scores across various appointment features by style of appointment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".