Wootton Richard, Bonnardot Laurent
National Centre for Integrated Care and Telemedicine, University Hospital of North Norway , Tromsø , Norway.
JRSM Short Rep. 2010 Oct 1;1(5):37. doi: 10.1258/shorts.2010.010045.
To review papers reporting actual experience with telemedicine in developing countries and to summarize their findings, including the strength of the evidence.
A retrospective review was conducted. Study quality was assessed.
Four commonly-used electronic databases.
Study quality scores.
From a total of 202 potential articles, 38 relevant papers were identified. Thirty-four articles (89%) reported clinical experience and 14 articles (37%) reported the use of telemedicine for educational purposes. The quality of the reports was rather weak (median quality-score 3, on a scale 0-9); only one study, rated at 7, fell into the high quality score band. The fact that almost all studies reported positively in favour of telemedicine suggests a publication bias. Of the 38 articles, 15 (39%) reported the use of real-time telemedicine and 25 (66%) reported the use of asynchronous, or store-and-forward, telemedicine. Email was the most commonly reported modality (half of all studies).
Some of the longer established telemedicine operations have developed into substantial networks. The review suggests that great potential exists for telemedicine in the developing world. However, some caution is required in future telemedicine work if telemedicine exemplars are to be produced which can be widely copied.
回顾报告发展中国家远程医疗实际经验的论文，并总结其研究结果，包括证据的力度。
进行回顾性综述。评估研究质量。
四个常用的电子数据库。
研究质量得分。
从总共202篇潜在文章中，识别出38篇相关论文。34篇文章（89%）报告了临床经验，14篇文章（37%）报告了将远程医疗用于教育目的。报告的质量相当薄弱（质量得分中位数为3，范围为0至9）；只有一项评分为7的研究属于高质量得分范围。几乎所有研究都对远程医疗给出了积极的报告，这表明存在发表偏倚。在这38篇文章中，15篇（39%）报告了使用实时远程医疗，25篇（66%）报告了使用异步或存储转发远程医疗。电子邮件是最常报告的方式（占所有研究的一半）。
一些较早建立的远程医疗业务已发展成为大型网络。该综述表明，远程医疗在发展中世界存在巨大潜力。然而，如果要产生可被广泛效仿的远程医疗范例，未来的远程医疗工作需要谨慎。
