Digital healthcare consultations not enough for safe assessment of tonsillitis

Tonsillitis is a common reason for medical visits and antibiotic prescriptions in primary care. To determine whether a patient needs antibiotics, doctors use what are called central criteria for tonsillitis. Criteria include fever, tenderness and swelling of lymph nodes at the angle of the jaw, and tonsil examination.

However, it is unclear how well these criteria are assessed during digital health consultations compared with traditional face-to-face consultations. As digital medical consultations become more commonplace, the lack of scientific evidence has become a growing concern.

Digital and physical assessment

The current research is published in the journal infectious diseaseto examine whether digital assessments are as reliable as physical examinations in determining the need for antibiotic treatment. The study included 189 patients who sought treatment at medical clinics and urgent care clinics in the Västergötaland region of Sweden between January 2020 and October 2023.

Each patient in the study was evaluated twice: a digital medical evaluation via video and a physical examination by another doctor. The results showed that digital medical consultations were insufficient to assess some of the most important criteria, such as tonsil examinations and lymph node examinations.

Digitalization is not secure enough

One of the driving forces behind this research is Patrycja Woldan-Gradalska, a doctoral student at the Sahlgrenska Institute at the University of Gothenburg and a resident physician at the Satila Medical Clinic.

“Our study shows that while digital medical consultations are convenient for many patients, they are not reliable enough for assessing tonsillitis. A physical examination is still important to ensure proper diagnosis and treatment,” she said.

The author is active in the field of community medicine and public health at the Sahlgrenska Academy of the University of Gothenburg and at the FoUUI Primary and Community Healthcare (a support resource for research, education, development and innovation) in the Västra Götaland region.