Clinicopathological agreement following asynchronous remote and face-to-face oral medicine consultations: A retrospective comparative study

Abstract

Abstract Aims To compare agreement of assumed diagnosis (prior to recommended biopsy) of oral pathological lesions with final diagnosis (post biopsy), between remote and frontal consultations with an oral medicine specialist. Design and setting: We examined 386 consultations, for which specialists recommended a biopsy, and compared assumed and final diagnoses. Materials and Methods The study group included 190 patients whose clinicians remotely consulted with specialists, sending relevant information via WhatsApp. The control group included 196 patients who had a frontal consultation with a clinician and specialist. Results Cohen’s Kappa for assessing agreement between differential and final diagnoses indicated that for remote consultations, (κ) = 0.815; for frontal consultations, (κ) = 0.698. Agreement between presumptive and final diagnoses decreased indirectly with patient age (p = 0.015). More patients avoided biopsy in the remote consultation group (p < 0.001). Fewer reports were received from the remote consultations regarding smoking status (p < 0.001). Discussion Our results suggest that remote consultations are an effective tool, with substantial reliability. However, other findings point to a more complex reality and should be considered. Conclusions The approach of patients and therapists to consultations may differ between frontal and remote settings, with more avoidance of biopsies after remote consultations and older patients posing a greater diagnostic challenge.

The authors' abstract, as published at the source. Clinical Oral Investigations, 2026 · DOI ↗