Li Wanjin, Cheung Ronald, Malvankar-Mehta Monali S
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada; Department of Ophthalmology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
J AAPOS. 2022 Apr;26(2):58.e1-58.e7. doi: 10.1016/j.jaapos.2021.12.006. Epub 2022 Mar 17.
To synthesize the literature assessing the diagnostic accuracy of telemedicine evaluation compared with clinical examination for retinopathy of prematurity (ROP) in premature infants.
Covidence software was used to conduct a systematic literature search from September 14, 2020, through September 27, 2020, on MEDLINE (Ovid), EMBASE (Ovid), CINAHL, and the gray literature to identify studies relevant to telemedicine utilization for ROP detection. After duplicate removal and two-levels of screening, studies comparing telemedicine evaluation with binocular indirect ophthalmoscopic examination were included. Risk of bias assessment was conducted for the included studies following data extraction. A qualitative review was performed to summarize estimates of accuracy of ROP evaluation by telemedicine.
A total of 507 studies were reviewed, of which 323 were found in EMBASE, 115 in MEDLINE, and 79 in CINAHL. Three possibly relevant conference abstracts were found. Following duplicate removal, 410 studies were reviewed based on titles and abstracts. Subsequently, 19 articles were thoroughly examined, and 14 studies (2,655 participants) were included. Most studies found that telemedicine performance for detecting ROP was comparable to ophthalmic examination, especially with regard to identifying treatment-requiring ROP.
Telemedicine evaluation can reliably detect ROP. Incorporation of telemedicine into conventional neonatal care has the potential to improve access to ROP care.
综合评估远程医疗评估与临床检查对早产儿视网膜病变（ROP）诊断准确性的文献。
使用Covidence软件于2020年9月14日至2020年9月27日在MEDLINE（Ovid）、EMBASE（Ovid）、CINAHL以及灰色文献中进行系统的文献检索，以识别与利用远程医疗检测ROP相关的研究。在去除重复文献和进行两级筛选后，纳入比较远程医疗评估与双目间接检眼镜检查的研究。在数据提取后，对纳入的研究进行偏倚风险评估。进行定性综述以总结远程医疗评估ROP准确性的估计值。
共检索到507项研究，其中在EMBASE中找到323项，在MEDLINE中找到115项，在CINAHL中找到79项。发现3篇可能相关的会议摘要。去除重复文献后，基于标题和摘要对410项研究进行了审查。随后，对19篇文章进行了全面审查，纳入了14项研究（2655名参与者）。大多数研究发现，远程医疗检测ROP的性能与眼科检查相当，尤其是在识别需要治疗的ROP方面。
远程医疗评估能够可靠地检测ROP。将远程医疗纳入传统新生儿护理有可能改善ROP护理的可及性。
