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Xie, Yunyun; He, Wenjun; Wan, Yuting; Luo, Huanyuan; Cai, Yiyuan; Gong, Wenjie; Liu, Siyuan; Zhong, Dongmei; Hu, Wenping; & Zhang, Lanping, et al. (2023). Validity of Patients’ Online Reviews at Direct-To-Consumer Teleconsultation Platforms: A Protocol for a Cross-Sectional Study Using Unannounced Standardised Patients. BMJ Open, 13(5), e071783. PMCID: PMC10173992


INTRODUCTION: As direct-to-consumer teleconsultation (hereafter referred to as 'teleconsultation') has gained popularity, an increasing number of patients have been leaving online reviews of their teleconsultation experiences. These reviews can help guide patients in identifying doctors for teleconsultation. However, few studies have examined the validity of online reviews in assessing the quality of teleconsultation against a gold standard. Therefore, we aim to use unannounced standardised patients (USPs) to validate online reviews in assessing both the technical and patient-centred quality of teleconsultations. We hypothesise that online review results will be more consistent with the patient-centred quality, rather than the technical quality, as assessed by the USPs.
METHODS AND ANALYSIS: In this cross-sectional study, USPs representing 11 common primary care conditions will randomly visit 253 physicians via the three largest teleconsultation platforms in China. Each physician will receive a text-based and a voice/video-based USP visit, resulting in a total of 506 USP visits. The USP will complete a quality checklist to assess the proportion of clinical practice guideline-recommended items during teleconsultation. After each visit, the USP will also complete the Patient Perception of Patient-Centeredness Rating. The USP-assessed results will be compared with online review results using the intraclass correlation coefficient (ICC). If ICC >0.4 (p<0.05), we will assume reasonable concordance between the USP-assessed quality and online reviews. Furthermore, we will use correlation analysis, Lin's Coordinated Correlation Coefficient and Kappa as supplementary analyses.
ETHICS AND DISSEMINATION: This study has received approval from the Institutional Review Board of Southern Medical University (#Southern Medical Audit (2022) No. 013). Results will be actively disseminated through print and social media, and USP tools will be made available for other researchers.


Reference Type

Journal Article

Year Published


Journal Title

BMJ Open


Xie, Yunyun
He, Wenjun
Wan, Yuting
Luo, Huanyuan
Cai, Yiyuan
Gong, Wenjie
Liu, Siyuan
Zhong, Dongmei
Hu, Wenping
Zhang, Lanping
Li, Jiaqi
Zhao, Qing
Lv, Sensen
Li, Chunping
Zhang, Zhang
Li, Changchang
Chen, Xiaoshan
Huang, Wangqing
Wang, Yutong
Xu, Dong Roman

Article Type