Digital health care consultations not enough for safe assessment of tonsillitis

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

However, it has been unclear how well these criteria can be assessed during digital health care consultations compared to traditional in-person consultations. This lack of scientific evidence has become a growing concern as digital health care consultations become more common.

Digital vs. physical assessment

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

Each patient in the study underwent two assessments: a digital medical assessment via video and a physical examination conducted by another doctor. The results show that digital health care consultations are not sufficient to assess some of the most important criteria, such as tonsil inspection and lymph node examination.

Digital not safe enough

One of the driving forces behind the study is Patrycja Woldan-Gradalska, a Ph.D. student at Sahlgrenska Academy at the University of Gothenburg and a Resident Physician at Sätila Health care Clinic.

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