Center for Spine Health, Cleveland Clinic Foundation, USA.
School of Medicine, Case Western Reserve University, USA.
J Telemed Telecare. 2021 Jun;27(5):261-268. doi: 10.1177/1357633X211015548. Epub 2021 May 18.
In 2017, the American Association of Neurological Surgeons and Congress of Neurological Surgeons published a statement in support of adopting telemedicine technologies in neurosurgery. The position statement detailed the principles for use and summarised the active efforts at the time to address barriers that limited expansion of use, such as reimbursement, liability, credentialing and patient confidentiality. The primary aim of this systematic literature review was to identify the available published literature on the application of telemedicine to neurosurgical patient care, with a specific focus on neurotrauma and emergent neurological conditions.
This Level II systematic review of the literature was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines. Following removal of duplicates, 359 studies were yielded from database query. Following application of inclusion and exclusion criteria, 78 articles were identified for full-text review.
Full-text screening yielded a total of 11 studies for the final analysis. The study interventions took place in seven unique countries and included both developed and developing nations. Data captured spanned the years 1997 to 2019. The total cumulative number of patients who received neurosurgical telemedicine consultations captured by this review was 37,224.
This review of the literature suggests that telemedicine in emergent settings offers safe, feasible, and cost-reducing methods of increasing access to high acuity neurosurgical care and may serve to limit unnecessary inter-facility transfers. As infrastructure and regulatory guidelines continue to evolve, neurosurgical patients, both domestic and abroad, will benefit from improved access to expertise afforded by telemedicine technologies.
2017 年，美国神经外科学会和神经外科学会发表了一份声明，支持在神经外科中采用远程医疗技术。该立场声明详细说明了使用原则，并总结了当时为解决限制使用扩大的障碍而采取的积极努力，例如报销、责任、认证和患者保密性。本系统文献综述的主要目的是确定有关远程医疗在神经外科患者护理中应用的现有文献，特别关注神经创伤和紧急神经状况。
这是一项按照 2009 年系统评价和荟萃分析首选报告项目的 II 级系统文献综述。在去除重复项后，从数据库查询中获得了 359 项研究。在应用纳入和排除标准后，确定了 78 篇文章进行全文审查。
全文筛选共得出 11 项最终分析研究。研究干预措施发生在七个独特的国家，包括发达国家和发展中国家。捕获的数据跨越了 1997 年至 2019 年。本综述共纳入 37224 例接受神经外科远程医疗咨询的患者。
这项文献综述表明，紧急情况下的远程医疗提供了安全、可行且降低成本的方法，可以增加获得高 acuity 神经外科护理的机会，并有助于限制不必要的机构间转院。随着基础设施和监管指南的不断发展，国内外神经外科患者将受益于远程医疗技术提供的更好的专家咨询机会。
