Trauma & Orthopaedics, Royal Free London NHS Foundation Trust, Barnet Hospital, London, UK.
Trauma & Orthopaedics, Ealing Hospital, London, UK.
J Telemed Telecare. 2022 Jul;28(6):391-403. doi: 10.1177/1357633X20938241. Epub 2020 Aug 6.
Telemedicine is the delivery of healthcare across a distance using some form of communication technology. The COVID-19 pandemic has led to increased adoption of telemedicine with national orthopaedic governing bodies advocating its use, as evidence suggests that social distancing maybe necessary until 2022. This systematic review aims to explore evidence for telemedicine in orthopaedics to determine its advantages, validity, effectiveness and utilisation.
Databases of PubMed, Web of Science, Scopus and CINAHL were systematically searched and articles were included if they involved any form of telephone or video consultation in an orthopaedic population. Findings were synthesised into four themes: patient/clinician satisfaction, accuracy and validity of examination, safety and patient outcomes and cost effectiveness. Quality assessment was undertaken using Cochrane and Joanna Briggs Institute appraisal tools.
Twenty-one studies were included consisting of nine randomised controlled trials (RCTs). Studies revealed high patient satisfaction with telemedicine for convenience, less waiting and travelling time. Telemedicine was cost effective particularly if patients had to travel long distances, required hospital transport or time off work. No clinically significant differences were found in patient examination nor measurement of patient-reported outcome measures. Telemedicine was reported to be a safe method of consultation.
Evidence suggests that telemedicine in orthopaedics can be safe, cost effective, valid in clinical assessment and with high patient/clinician satisfaction. However, more high-quality RCTs are required to elucidate long-term outcomes. This systematic review presents up-to-date evidence on the use of telemedicine and provides data for organisations considering its use during the COVID-19 pandemic and beyond.
远程医疗是通过某种形式的通信技术在远距离提供医疗保健。COVID-19 大流行导致远程医疗的采用率增加，国家骨科管理机构提倡使用远程医疗，因为有证据表明，可能需要保持社交距离直到 2022 年。本系统评价旨在探讨远程医疗在骨科中的应用证据，以确定其优势、有效性、有效性和利用率。
系统检索 PubMed、Web of Science、Scopus 和 CINAHL 数据库，如果涉及任何形式的电话或视频咨询在骨科人群中，将纳入文章。研究结果综合为四个主题：患者/临床医生满意度、检查的准确性和有效性、安全性和患者结局以及成本效益。使用 Cochrane 和 Joanna Briggs 研究所评估工具进行质量评估。
共纳入 21 项研究，包括 9 项随机对照试验（RCT）。研究表明，患者对远程医疗的便利性、等待和旅行时间减少非常满意。如果患者需要长途旅行、需要医院交通或休假，远程医疗具有成本效益。在患者检查或测量患者报告的结果测量方面未发现临床意义上的差异。报告称远程医疗是一种安全的咨询方法。
证据表明，远程医疗在骨科中是安全、具有成本效益的，在临床评估中有效，且患者/临床医生满意度高。然而，需要更多高质量的 RCT 来阐明长期结果。本系统评价介绍了远程医疗使用的最新证据，并为考虑在 COVID-19 大流行期间及以后使用远程医疗的组织提供了数据。
