恶性血液病和非恶性血液病的远程医疗:儿科和成人研究的系统评价。

Telemedicine in Malignant and Nonmalignant Hematology: Systematic Review of Pediatric and Adult Studies.

机构信息

Department of Medical Education, University of Illinois College of Medicine, Chicago, IL, United States.

Galter Health Sciences Library and Learning Center, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.

出版信息

JMIR Mhealth Uhealth. 2021 Jul 8;9(7):e29619. doi: 10.2196/29619.

Abstract

BACKGROUND

Telemedicine, including video-, web-, and telephone-based interventions, is used in adult and pediatric populations to deliver health care and communicate with patients. In the realm of hematology, telemedicine has recently been used to safely and efficiently monitor treatment side-effects, perform consultations, and broaden the reach of subspecialty care.

OBJECTIVE

We aimed to synthesize and analyze information regarding the feasibility, acceptability, and potential benefits of telemedicine interventions in malignant and nonmalignant hematology, as well as assess the recognized limitations of these interventions.

METHODS

Studies were identified through a comprehensive Medical Subject Headings (MeSH) search on the PubMed MEDLINE, Controlled Register of Clinical Trials (Cochrane CENTRAL from Wiley), Embase, and CINAHL (EBSCO) databases on February 7, 2018. A second search, utilizing the same search strategy, was performed on October 1, 2020. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the reporting of included evidence. Included studies were original articles researching the feasibility, acceptability, and clinical outcomes of telemedicine or telehealth interventions in pediatric or adult populations with malignant or nonmalignant hematological conditions. Data items in the extraction form included first author name, publication year, country, malignant or nonmalignant hematological condition or disease focus of the study, participant age, participant age subgroup (pediatric or adult), study design and setting, telemedicine intervention type and description, study purpose, and main study outcomes.

RESULTS

A total of 32 articles met the preset criteria and were included in this study. Most (25/32) studies were conducted in adults, and the remaining (7/32) were conducted in the pediatric population. Of the 32 studies, 12 studied malignant hematological conditions, 18 studied nonmalignant conditions, and two studied both malignant and nonmalignant conditions. Study types included pilot study (11/32), retrospective study (9/32), randomized controlled trial (6/32), cross-sectional study (2/32), case study (1/32), pre-post study (1/32), noncomparative prospective study (1/32), and prospective cohort study (1/32). The three main types of telemedicine interventions utilized across all studies were video-based (9/32), telephone-based (9/32), and web-based interventions (14/32). Study results showed comparable outcomes between telemedicine and traditional patient encounter groups across both pediatric and adult populations for malignant and nonmalignant hematological conditions.

CONCLUSIONS

Evidence from this review suggests that telemedicine use in nonmalignant and malignant hematology provides similar or improved health care compared to face-to-face encounters in both pediatric and adult populations. Telemedicine interventions utilized in the included studies were well received in both pediatric and adult settings. However, more research is needed to determine the efficacy of implementing more widespread use of telemedicine for hematological conditions.

摘要

背景

远程医疗,包括视频、网络和电话为基础的干预措施,用于向成人和儿科患者提供医疗保健和与患者进行沟通。在血液学领域,远程医疗最近已被用于安全有效地监测治疗副作用、进行咨询以及扩大专科护理的范围。

目的

我们旨在综合分析远程医疗干预在恶性和非恶性血液病中的可行性、可接受性和潜在益处,并评估这些干预措施的公认局限性。

方法

我们通过在 2018 年 2 月 7 日对 PubMed MEDLINE、临床试验对照注册(Wiley 旗下 Cochrane CENTRAL)、Embase 和 CINAHL(EBSCO)数据库进行全面的医学主题词(MeSH)搜索,确定了研究。2020 年 10 月 1 日进行了第二次搜索,使用相同的搜索策略。我们在报告纳入的证据时遵循了系统评价和荟萃分析的首选报告项目(PRISMA)指南。纳入的研究是关于儿科或成年人群中恶性或非恶性血液学疾病的远程医疗或远程健康干预的可行性、可接受性和临床结果的原始文章。提取表格中的数据项包括第一作者姓名、出版年份、国家、研究的恶性或非恶性血液病或疾病重点、参与者年龄、参与者年龄亚组(儿科或成年)、研究设计和设置、远程医疗干预类型和描述、研究目的以及主要研究结果。

结果

共有 32 篇文章符合预设标准并被纳入本研究。大多数(25/32)研究是在成人中进行的,其余(7/32)是在儿科人群中进行的。在 32 项研究中,有 12 项研究恶性血液病,18 项研究非恶性疾病,2 项研究恶性和非恶性疾病。研究类型包括试点研究(11/32)、回顾性研究(9/32)、随机对照试验(6/32)、横断面研究(2/32)、病例研究(1/32)、前后研究(1/32)、非比较前瞻性研究(1/32)和前瞻性队列研究(1/32)。所有研究中使用的三种主要远程医疗干预类型是基于视频的(9/32)、基于电话的(9/32)和基于网络的干预(14/32)。研究结果表明,在儿科和成年人群中,恶性和非恶性血液病的远程医疗组与传统患者就诊组的结果相当或更好。纳入研究中的远程医疗干预措施在儿科和成年环境中均受到好评。然而,需要进一步的研究来确定在血液学疾病中更广泛地实施远程医疗的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df70/8299344/87793864df46/mhealth_v9i7e29619_fig1.jpg

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