Digital consultations are not reliable for the assessment of tonsillitis

Digital healthcare consultations are not enough to safely assess tonsillitis, according to a study from the University of Gothenburg. Reliability will not be sufficient, thus increasing the risk of over- or under-treating a sore throat.

Tonsillitis is a common reason for doctor visits and antibiotic prescriptions in primary care. To determine whether a patient needs antibiotics, doctors use the so-called Centor Criteria for tonsillitis. Criteria include fever, tender and swollen lymph nodes at the angles of the jaw, and inspection of the tonsils.

However, it was unclear how well these criteria can be assessed during digital health care consultations compared to traditional face-to-face consultations. This lack of scientific evidence has become a growing concern as consultations on digital healthcare become more frequent.

Digital vs. physical assessment

The current study, published in the journal Infectious Diseasesexamines whether digital assessments are as reliable as physical examinations in determining whether antibiotic therapy is warranted. The study includes 189 patients who sought care at health care clinics and urgent care clinics in Västra Götaland, Sweden, between January 2020 and October 2023.

Each patient in the study underwent two evaluations: a digital video medical evaluation and a physical exam performed by another physician. The results show that digital health consultations are not sufficient to assess some of the most important criteria, such as tonsil inspection and lymph node examination.

Digital is not secure enough

One of the driving forces behind the study is Patrycja Woldan-Gradalska, a PhD student at the Sahlgrenska Academy at the University of Gothenburg and resident physician at the Sätila Healthcare clinic.

Our study shows that although digital healthcare consultations are convenient for many patients, they are not reliable enough to assess tonsillitis. To ensure proper diagnosis and treatment, it is still important to conduct a physical examination.”

Patrycja Woldan-Gradalska, PhD at Sahlgrenska Academy, University of Gothenburg

The authors are active in community medicine and public health at the Sahlgrenska Academy at the University of Gothenburg and the FoUUI primary and community healthcare of the Västra Götaland region, a source of support for research, education, development and innovation.