Lee Yejin, Raviglione Mario C, Flahault Antoine
Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Global Studies Institute, University of Geneva, Geneva, Switzerland.
J Med Internet Res. 2020 Feb 13;22(2):e15727. doi: 10.2196/15727.
Tuberculosis (TB) is the leading cause of death from a single infectious agent, with around 1.5 million deaths reported in 2018, and is a major contributor to suffering worldwide, with an estimated 10 million new cases every year. In the context of the World Health Organization's End TB strategy and the quest for digital innovations, there is a need to understand what is happening around the world regarding research into the use of digital technology for better TB care and control.
The purpose of this scoping review was to summarize the state of research on the use of digital technology to enhance TB care and control. This study provides an overview of publications covering this subject and answers 3 main questions: (1) to what extent has the issue been addressed in the scientific literature between January 2016 and March 2019, (2) which countries have been investing in research in this field, and (3) what digital technologies were used?
A Web-based search was conducted on PubMed and Web of Science. Studies that describe the use of digital technology with specific reference to keywords such as TB, digital health, eHealth, and mHealth were included. Data from selected studies were synthesized into 4 functions using narrative and graphical methods. Such digital health interventions were categorized based on 2 classifications, one by function and the other by targeted user.
A total of 145 relevant studies were identified out of the 1005 published between January 2016 and March 2019. Overall, 72.4% (105/145) of the research focused on patient care and 20.7% (30/145) on surveillance and monitoring. Other programmatic functions 4.8% (7/145) and electronic learning 2.1% (3/145) were less frequently studied. Most digital health technologies used for patient care included primarily diagnostic 59.4% (63/106) and treatment adherence tools 40.6% (43/106). On the basis of the second type of classification, 107 studies targeted health care providers (107/145, 73.8%), 20 studies targeted clients (20/145, 13.8%), 17 dealt with data services (17/145, 11.7%), and 1 study was on the health system or resource management. The first authors' affiliations were mainly from 3 countries: the United States (30/145 studies, 20.7%), China (20/145 studies, 13.8%), and India (17/145 studies, 11.7%). The researchers from the United States conducted their research both domestically and abroad, whereas researchers from China and India conducted all studies domestically.
The majority of research conducted between January 2016 and March 2019 on digital interventions for TB focused on diagnostic tools and treatment adherence technologies, such as video-observed therapy and SMS. Only a few studies addressed interventions for data services and health system or resource management.
结核病是单一传染源导致死亡的首要原因，2018年报告的死亡人数约为150万，是全球痛苦的主要根源，估计每年有1000万新发病例。在世界卫生组织终止结核病战略及追求数字创新的背景下，有必要了解全球在利用数字技术改善结核病护理与控制方面的研究进展。
本综述的目的是总结利用数字技术加强结核病护理与控制的研究现状。本研究概述了涵盖该主题的出版物，并回答3个主要问题：（1）2016年1月至2019年3月期间，该问题在科学文献中的涉及程度如何；（2）哪些国家在该领域进行了研究投资；（3）使用了哪些数字技术？
在PubMed和Web of Science上进行基于网络的搜索。纳入了特别提及结核病、数字健康、电子健康和移动健康等关键词来描述数字技术使用情况的研究。使用叙述和图形方法将所选研究的数据综合为4种功能。此类数字健康干预措施根据两种分类进行归类，一种按功能分类，另一种按目标用户分类。
在2016年1月至2019年3月发表的1005篇文献中，共识别出145项相关研究。总体而言，72.4%（105/145）的研究聚焦于患者护理，20.7%（30/145）聚焦于监测和监控。其他项目功能（4.8%，7/145）和电子学习（2.1%，3/145）的研究较少。用于患者护理的大多数数字健康技术主要包括诊断工具（59.4%，63/106）和治疗依从性工具（40.6%，43/106）。基于第二种分类，107项研究针对医疗保健提供者（107/145，73.8%），20项研究针对客户（20/145，13.8%），17项涉及数据服务（17/145，11.7%），1项研究涉及卫生系统或资源管理。第一作者的所属机构主要来自3个国家：美国（30/145项研究，20.7%）、中国（20/145项研究，13.8%）和印度（17/145项研究，11.7%）。美国的研究人员在国内外都开展了研究，而中国和印度的研究人员所有研究均在国内进行。
2016年1月至2019年3月期间开展的关于结核病数字干预措施的大多数研究聚焦于诊断工具和治疗依从性技术，如视频观察治疗和短信服务。仅有少数研究涉及数据服务以及卫生系统或资源管理方面的干预措施。
