Obstetrics and Gynaecology, Hillingdon Hospital NHS Trust, Uxbridge, UK
Queen Charlotte's Hospital, Imperial College Healthcare NHS Trust, London, UK.
BMJ Open. 2020 Dec 7;10(12):e039457. doi: 10.1136/bmjopen-2020-039457.
The aim of this systematic review is to examine the use of telemedicine in the delivery and teaching of gynaecological clinical practice. To our knowledge, no other systematic review has assessed this broad topic.
Systematic review of all studies investigating the use of telemedicine in the provision of gynaecological care and education. The search for eligible studies followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and focused on three online databases: PubMed, Science Direct and SciFinder.
Only studies within gynaecology were considered for this review. Studies covering only obstetrics and with minimal information on gynaecology, or clinical medicine in general were excluded. All English language, peer-reviewed human studies were included. Relevant studies published up to the date of final submission of this review were considered with no restrictions to the publication year.
Data extracted included author details, year of publication and country of the study, study aim, sample size, methodology, sample characteristics, outcome measures and a summary of findings. Data extraction and qualitative assessment were performed by the first author and crossed checked by the second author. Quality assessment for each study was assessed using the Newcastle-Ottawa scale.
A literature search carried out in August 2020 yielded 313 records published between 1992 and 2018. Following a rigorous selection process, only 39 studies were included for this review published between 2000 and 2018. Of these, 19 assessed gynaecological clinical practice, eight assessed gynaecological education, one both, and 11 investigated the feasibility of telemedicine within gynaecological practice. 19 studies were classified as good, 12 fair and eight poor using the Newcastle-Ottawa scale. Telecolposcopy and abortion care were two areas where telemedicine was found to be effective in potentially speeding up diagnosis as well as providing patients with a wide range of management options. Studies focusing on education demonstrated that telementoring could improve teaching in a range of scenarios such as live surgery and international teleconferencing.
The results of this review are promising and demonstrate that telemedicine has a role to play in improving clinical effectiveness and education within gynaecology. Its applications have been shown to be safe and effective in providing remote care and training. In the future, randomised controlled studies involving larger numbers of patients and operators with measurable outcomes are required in order to be able to draw reliable conclusions.
本系统评价旨在研究远程医疗在妇科临床实践中的应用和教学。据我们所知，尚无其他系统评价评估过这个广泛的主题。
对所有研究远程医疗在妇科护理和教育中的应用的研究进行系统评价。符合条件的研究的搜索遵循系统评价和荟萃分析的首选报告项目，并集中在三个在线数据库上：PubMed、Science Direct 和 SciFinder。
本综述仅考虑妇科领域的研究。仅涵盖产科且对妇科或一般临床医学信息较少的研究，或不包括临床研究。所有英语同行评议的人类研究均包括在内。考虑到本综述最终提交日期之前发表的相关研究，没有对发表年份的限制。
提取的数据包括作者详细信息、发表年份和研究国家、研究目的、样本量、方法、样本特征、结果测量和研究结果总结。数据提取和定性评估由第一作者进行，并由第二作者交叉检查。使用纽卡斯尔-渥太华量表对每项研究进行质量评估。
2020 年 8 月进行的文献检索产生了 1992 年至 2018 年期间发表的 313 条记录。经过严格的选择过程，本综述仅纳入了 2000 年至 2018 年期间发表的 39 项研究。其中，19 项评估了妇科临床实践，8 项评估了妇科教育，1 项同时评估了两者，11 项研究调查了妇科实践中远程医疗的可行性。19 项研究被归类为良好，12 项为中等，8 项为差，使用纽卡斯尔-渥太华量表进行评估。远程阴道镜检查和流产护理是远程医疗被发现能够有效加快诊断速度并为患者提供广泛管理选择的两个领域。专注于教育的研究表明，远程指导可以改善各种场景下的教学，如现场手术和国际远程会议。
本综述的结果很有希望，表明远程医疗在提高妇科临床效果和教育方面发挥着作用。其应用已被证明在提供远程护理和培训方面是安全有效的。未来，需要进行涉及更多患者和操作人员的随机对照研究，并具有可衡量的结果，以便能够得出可靠的结论。
