Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Ann Acad Med Singap. 2021 Jan;50(1):61-76. doi: 10.47102/annals-acadmedsg.2020459.
Teleophthalmology may assist the healthcare sector in adapting to limitations imposed on clinical practice by a viral pandemic. A scoping review is performed in this study to assess the current applications of teleophthalmology for its suitability to diagnose, monitor or manage ophthalmological conditions with accuracy.
A search of PubMed was conducted for teleophthalmology-related articles published from 1 January 2018 to 4 May 2020. Only articles that focused on the use of teleophthalmology in terms of diagnosis and management, as well as its benefits and detriments, were included. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included articles.
A total of 38 articles were assessed at the full-text level. There were 2 qualitative studies and 1 quantitative randomised controlled trial, while the majority were either quantitative descriptive studies (19, 50.0%) or quantitative non-randomised studies (16, 42.1%). Overall, 8 studies described reducing manpower requirements, 4 described reducing direct patient-doctor contact, 17 described storage of medical imaging and clinical data, and 9 described real-time teleconferencing. The MMAT analysis revealed limitations in appropriate sampling strategy in both quantitative non-randomised studies (9 of 16, 56.3%) and quantitative descriptive studies (9 of 19, 47.4%). Cost-effectiveness of teleophthalmology was not performed in any included study.
This current review of the various aspects of teleophthalmology describes how it may potentially assist the healthcare sector to cope with the limitations imposed by a viral pandemic through technology. Further research is required to evaluate the cost-effectiveness of the various strategies.
远程眼科学可以帮助医疗保健部门适应由病毒大流行对临床实践施加的限制。本研究进行了范围综述,以评估远程眼科学在准确诊断、监测或管理眼科疾病方面的当前应用,以确定其适用性。
对 2018 年 1 月 1 日至 2020 年 5 月 4 日发表的与远程眼科学相关的文章进行了 PubMed 搜索。仅纳入了聚焦于远程眼科学在诊断和管理方面的应用,以及其优缺点的文章。使用混合方法评估工具(MMAT)评估纳入文章的质量。
共对 38 篇全文进行了评估。其中有 2 项定性研究和 1 项定量随机对照试验,而大多数是定量描述性研究(19 项,50.0%)或定量非随机研究(16 项,42.1%)。总体而言,有 8 项研究描述了减少人力需求,4 项研究描述了减少直接医患接触,17 项研究描述了医学成像和临床数据的存储,9 项研究描述了实时远程会议。MMAT 分析显示,在定量非随机研究(16 项中的 9 项,56.3%)和定量描述性研究(19 项中的 9 项,47.4%)中均存在适当抽样策略的局限性。纳入的研究均未对远程眼科学的成本效益进行评估。
本综述从各个方面描述了远程眼科学如何通过技术帮助医疗保健部门应对病毒大流行带来的限制。需要进一步研究来评估各种策略的成本效益。