García-Lizana Francisca, Sarría-Santamera Antonio
Agency for Health Technology Assessment, Institute of Health Carlos III, Madrid, Spain.
J Telemed Telecare. 2007;13(2):62-8. doi: 10.1258/135763307780096140.
We conducted a systematic review of the clinical effectiveness of interventions using information and communication technologies (ICTs) for managing and controlling chronic diseases. Electronic databases were searched for randomized clinical trials that assessed the effectiveness of ICTs (except for those that included only telephone communication) and measured some clinical indicator. Information was reviewed and assessed independently by two researchers. Of the 950 clinical trials identified, 56 studies were identified for potential inclusion. Of those, 24 were finally included: 5 studies in asthma, 3 in hypertension, 1 in home telecare, 7 in diabetes, 6 in heart failure and 2 in prevention heart disease. Overall, ICT applications did not show an improvement in clinical outcomes, although no adverse effects were identified. However, ICTs used in the detection and follow up of cardiovascular diseases provided better clinical outcomes, mortality reduction and lower health services utilization. Systems used for improving education and social support were also shown to be effective. At present the evidence about the clinical benefits of ICTs for managing chronic disease is limited.
我们对使用信息通信技术（ICTs）管理和控制慢性病的干预措施的临床效果进行了系统评价。检索电子数据库，查找评估ICTs有效性（不包括仅涉及电话通信的研究）并测量了某些临床指标的随机临床试验。由两名研究人员独立审查和评估信息。在识别出的950项临床试验中，确定了56项研究可能纳入。其中，最终纳入24项：5项关于哮喘，3项关于高血压，1项关于家庭远程护理，7项关于糖尿病，6项关于心力衰竭，2项关于预防心脏病。总体而言，尽管未发现不良反应，但ICT应用并未显示出临床结局有所改善。然而，用于心血管疾病检测和随访的ICTs提供了更好的临床结局、降低了死亡率并减少了卫生服务利用。用于改善教育和社会支持的系统也显示出有效。目前，关于ICTs对慢性病管理的临床益处的证据有限。
