A rapid review of the effectiveness of remote consultations versus face-to-face consultations in secondary care surgical outpatient settings

The use of remote consultations and telemedicine approaches significantly increased over the pandemic. There is evidence that some patients still prefer this mode of care delivery and time saving may also enable additional consultations and help to reduce waiting lists. However, the effectiveness of remote consulting for certain specialities, such as surgery, is unclear. The aim of this review was to investigate the effectiveness of video or telephone consultations, particularly focusing on clinical, patient reported and safety outcomes, in adult secondary surgical outpatient care during the COVID-19 pandemic. 14 studies were identified. These were published in 2021-2022. Evidence is low or very-low quality due to observational study designs, small sample sizes and patient selection. Policy and practice implications: Evidence is of low quality but suggests that for many surgical outpatient consultations, remote consultations are as effective as in-person consultations. There is potential for time and cost savings for remote consultations compared to in-person consultations. High quality research is needed to evaluate the effectiveness of remote consultations to understand which patients and which surgical specialities would benefit most. Funding statement The Wales Centre for Evidence Based Care was funded for this work by the Wales COVID-19 Evidence Centre, itself funded by Health & Care Research Wales on behalf of Welsh Government. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The Wales Centre for Evidence Based Care was funded for this work by the Wales COVID-19 Evidence Centre, itself funded by Health & Care Research Wales on behalf of Welsh Government ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors * APP : Advanced practice professional ASA : American Society of Anaesthesiologists Physical Status Classifications CI : Confidence interval CTR : Carpal tunnel release CTS : Carpal tunnel syndrome CTS-6 : Carpal tunnel syndrome 6-item evaluation tool ED : Emergency department GRADE : Grading of Recommendations Assessment, Development and Evaluation IP : In-person IPC : In-person cohort NHS : National Health Service OR : Odd ratio PAT : Pre-anaesthesia testing POV : Postoperative visit PRISMA : Preferred Reporting Items for Systematic Reviews and Meta-Analyses SD : Standard deviation SIGN : Scottish Intercollegiate Guidelines Network TeC : Telephone cohort TM : Telemedicine TMC : Telemedicine cohort UK : United Kingdom USA : Unites States of America WHO : World Health Organisation