Comparing Outcomes of Musculoskeletal Radiographs from In-Person and Telemedicine Primary Care Cohorts, April 2019–June 2021

Article Figures & Data

Table 1.

Patient Characteristics and Association with Telemedicine Use^a

		Patients with visits after April 2020 (n = 504)
Characteristic	Overall (n = 995)	Did Not Utilize Telemedicine (n = 418)	Utilized Telemedicine (n = 89)	OR (95% CI)	p-Value
Gender				1.59 (0.98–2.59)	0.062
Man	372 (37.4)	175 (42.2)	28 (31.5)
Woman	623 (62.6)	240 (57.8)	61 (68.5)
Race					0.965
White	668 (67.1)	279 (68.7)	59 (67.8)
African American	188 (18.9)	79 (19.5)	18 (20.7)
Other	112 (11.3)	48 (11.8)	10 (11.5)
Ethnicity				0.444 (0.196–1.01)	0.05
Not Hispanic/Latinx	831 (83.5)	336 (83.4)	79 (91.9)
Hispanic/Latinx	131 (13.2)	67 (16.6)	7 (8.1)
Language				0.249 (0.033–1.90)	0.221
English	945 (95.0)	394 (95.6)	88 (98.9)
Other	46 (4.6)	18 (4.4)	1 (1.1)
Payor Group					0.586
Commercial	346 (34.8)	139 (43.0)	43 (48.9)
Medicaid	8 (0.8)	3 (0.9)	2 (2.3)
Medicare	261 (26.2)	93 (28.8)	24 (27.3)
Medicare Advantage	211 (21.2)	83 (25.7)	18 (20.5)
Other	18 (1.8)	5 (1.5)	1 (1.1)
Age (yrs)	62.94 ± 15.22	62.43 ± 15.27	59.71 ± 14.97		0.078
Age-adjusted CCI	3.68 ± 2.03	3.60 ± 2.02	3.66 ± 1.96		0.875
Median household income ($)	58,942 ± 22,146	58,380 ± 21,701	57, 065 ± 22,240		0.552

Abbreviations: OR, Odds ratio; CI, Confidence interval; CCI, Charleson comorbidity index.
a Data presented as N (%) or mean ± standard deviation.

Table 2.

Comparisons between Outcomes for Radiographs Ordered at In-Person and Telemedicine Visits, Pre- and Post-Pandemic Onset

Comparisons^a	Normal Findings^b	Abnormal Findings^b	OR (95% CI)	p-Value
1. Post-onset, in-person versus telemedicine			2.51 (1.33–4.75)	0.004
Post-onset, in-person	47 (10.9)	384 (89.1)
Post-onset, telemedicine	16 (23.5)	52 (76.5)
2. In-person, post-versus pre-onset			1.88 (1.30–2.71)	<0.001
Post-onset, in-person	47 (10.9)	384 (89.1)
Pre-onset, in-person	107 (18.7)	466 (81.3)

Table 3.

Outcomes of Musculoskeletal Radiographs by Visit Type, and Breakdown of the Primary Finding of Abnormal Radiographs

	Before Onset, In-person^a	After Onset, In-person^a	After Onset, Telemedicine^a
Missing	239	205	64
Normal findings	107 (18.7)	47 (10.9)	16 (23.5)
Abnormal findings	466 (81.3)	384 (89.1)	52 (76.5)
Primary abnormality:
Spinal spondylosis	157 (27.4)	95 (22.0)	17 (25.0)
Fracture	20 (3.5)	29 (6.7)	2 (2.9)
Mild osteoarthritis	140 (24.4)	119 (27.6)	16 (23.5)
Moderate/advanced osteoarthritis	88 (15.4)	83 (19.3)	12 (17.6)
Other diagnosis^b	61 (10.6)	58 (13.5)	5 (7.4)

↵a Data presented as N(%). Percentages are calculated excluding missing results.
↵b Other diagnoses included calcific tendinitis, enthesopathy, erosions (2 radiographs), joint effusion, osteomyelitis (1 radiograph), osteopenia, postsurgical changes, and soft tissue changes.