{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T16:26:46Z","timestamp":1784910406964,"version":"3.55.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100016483","name":"Duke Institute for Health Innovation","doi-asserted-by":"publisher","award":["2019040104"],"award-info":[{"award-number":["2019040104"]}],"id":[{"id":"10.13039\/100016483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Telemed Telecare"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The purpose of this study is to measure the comparative diagnostic accuracy of telehealth diagnostic examinations for pathologies of the shoulder against an in-person examination. The telehealth examinations were hypothesized to be non-inferior to in-person examinations for accuracy and to demonstrate fair to moderate agreement. This is an expanded study of a data set included in a prior publication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients underwent in-person standardized clinical examination (SCE) and standardized telehealth examination (STE) during the same visit by two different providers in randomized order. Tests were analyzed for sensitivity, specificity, agreement, and diagnostic accuracy using a nonarthrographic shoulder MRI as a reference standard, and divided into tests for rotator cuff tears (RCTs), glenohumeral arthritis (GHA), and acromioclavicular (AC) joint arthropathy. A pooled diagnostic accuracy was created for SCE and STE and directly compared using a Mann\u2013Whitney\n                      <jats:italic toggle=\"yes\">U<\/jats:italic>\n                      test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty-two patients, average age of 57.9 years (\u00b111.2), with 60 patients obtaining an MRI, were included in this study. There were no significant differences in the pooled diagnostic accuracy of identifying RCT, GHA, or AC arthropathy between SCE and STE (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.495, .469, .333, respectively). The highest agreement between SCE and STE was observed for the shoulder shrug test, night pain, and internal rotation limitation for identifying RCT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>STE demonstrated non-inferior pooled diagnostic accuracy in comparison to SCE for full-thickness RCT, GHA, and AC joint arthropathy. Secondarily, there was moderate to substantial agreement for selective tests, with a considerable portion ranging from fair to substantial agreement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1357633x251375155","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T18:40:24Z","timestamp":1758825624000},"page":"522-531","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Telehealth physical examinations show comparable accuracy and results to clinical exams for MRI confirmed shoulder pathologies"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7349-1475","authenticated-orcid":false,"given":"Mark A","family":"Glover","sequence":"first","affiliation":[{"name":"Duke University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendall E","family":"Bradley","sequence":"additional","affiliation":[{"name":"Duke University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M","family":"Casey","sequence":"additional","affiliation":[{"name":"Tennessee Orthopedic Alliance"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad","family":"Cook","sequence":"additional","affiliation":[{"name":"Duke University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily K","family":"Reinke","sequence":"additional","affiliation":[{"name":"Duke University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily N","family":"Vinson","sequence":"additional","affiliation":[{"name":"Duke University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard C","family":"Mather","sequence":"additional","affiliation":[{"name":"Duke University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Riboh","sequence":"additional","affiliation":[{"name":"Ortho Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tally","family":"Lassiter","sequence":"additional","affiliation":[{"name":"Duke University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn R","family":"Wittstein","sequence":"additional","affiliation":[{"name":"Duke University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/03009740310004667"},{"key":"e_1_3_3_3_2","first-page":"1211","article-title":"Disease and injury incidence and prevalence collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the global burden of disease study 2016","volume":"390","author":"GBD","year":"2016","unstructured":"GBD. Disease and injury incidence and prevalence collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the global burden of disease study 2016. 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