High diagnostic accuracy of chronic facial pain conditions via remote consultation

Background: This study aims to evaluate the diagnostic accuracy of chronic facial pain conditions through telephone consultations. Methods: Retrospective cross-sectional service evaluation of diagnosis during remote against face-to-face consultations were compared, based on international classification of orofacial pain. Clinical data from consecutive new patients were assessed from March–May 2020 at University College London Hospitals (UCLH)-Eastman Dental Hospital, UK, reviewed independently by two specialists. Exclusion criteria included non-English speakers, patients unable to engage in consultation, unrelated pain diagnoses at assessment and inadequate documentation. Accuracy test of sensitivity, specificity and predictive values were employed. Results: A total of 93 patients were included, and 6 orofacial pain diagnoses met. Nearly 25% had at least one imaging test, however none demonstrated underlying cause or change of diagnosis. Overall diagnostic accuracy was 97.85% with 100%sensitivity and specificity with perfect inter-rater agreement (kappa = 1). Only persistent idiopathic facial pain and post-traumatic neuropathic pain had reduced accuracy (98.9%) and positive predictive value (75% and 50% respectively), being 100% for all other conditions. Conclusions: This study showed high diagnostic accuracy for diagnosing facial pain remotely, corroborating previous reports. Further investigations and physical examinations have not changed the diagnosis or management plan. This study evidenced that remote structured consultations represent a safe strategy for accurate facial pain diagnosis that may improve clinical efficiency.

Facial pain; Telephone consultation; Diagnosis; Sensitivity

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