OBJECTIVES: Many services transitioned to telehealth during the SARS-CoV-2 pandemic. The Speech Language Pathology Primary Contact (SLPPC) assessment clinic is where people are seen by a Speech-Language Pathologist (SLP) for initial assessment prior to their Ear, Nose and Throat (ENT) examination for completion of diagnosis. This study investigates how the SLPPC model, adapted for telehealth (SLPPC-T), can triage patients with voice disorders (VD) for urgency of ENT laryngoscopy.

METHOD/DESIGN: A prospective observational cohort study examined patients using a hybrid telehealth/face-to-face triage model based on the SLPPC protocol. SLPs conducted virtual case history and voice assessments to prioritize patients for laryngoscopy. Study outcomes included: 1) association of SLPPC-T assessment findings with VD classification after laryngoscopy; 2) concordance between SLP priority for laryngoscopy after SLPPC-T and priority matched to ENT VD classification after laryngoscopy; 3) agreement between SLP and ENT VD classification post-laryngoscopy.

RESULTS: 103 participants (73 CIS females, 26 CIS males; mean age 57.66 years, range 23–86) were recruited. After the SLPPC-T assessment, 2 participants were prioritized for emergent laryngoscopy, 26 for priority laryngoscopy within 4 weeks, and 75 for routine laryngoscopy within 6 weeks. There was slight concordance between SLP priority for laryngoscopy after SLPPC-T and the priority matched to ENT VD classification after laryngoscopy (k=0.206), and substantial agreement between SLP and ENT on VD classification after SLP-led laryngoscopy with ENT imaging review (k=0.69). Logistic regression modelling of the association of SLPPC-T assessment data and laryngoscopy diagnosis will be presented.

CONCLUSION: SLPs decisions to prioritise people for urgent or routine laryngoscopy after virtual assessment was fair. SLPs and ENTs demonstrated comparable diagnostic and management decisions after laryngeal imaging. This study provides evidence supporting SLPs as a first point of contact for virtual triage of voice disorder patients. The findings provide evidence to inform a standardised model for SLP-led triage assessment.