Digital consultations not sufficient for treatment of tonsillitis, says study

Even as digital healthcare consultations are becoming more common, a study showed it may not be enough for a safe assessment of tonsillitis.

Tonsillitis is a painful infection of the tonsils—two lymph node-rich glands in the back of the throat. Symptoms of tonsillitis include swollen tonsils, sore throat, and difficulty swallowing.

The study showed that digital assessment may not be reliable, thus increasing the risk of over- or undertreatment of a sore throat.

As tonsillitis is commonly treated with antibiotics, digital assessment may not be as reliable as physical examinations in determining whether antibiotic treatment is warranted, said the team from the University of Gothenburg in Sweden.

To determine whether a patient needs antibiotics, doctors use the so-called Centor Criteria—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 healthcare consultations compared to traditional in-person consultations, said the researchers.

“Our study shows that although digital healthcare 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,” said Patrycja Woldan-Gradalska, a doctoral student at Sahlgrenska Academy at the varsity.

The study, published in the journal Infectious Diseases, included 189 patients who sought care at healthcare clinics and urgent care clinics in 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 healthcare consultations are not sufficient to assess some of the most important criteria, such as tonsil inspection and lymph node examination.