Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, United Kingdom.
NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.
J Neurotrauma. 2022 Oct;39(19-20):1289-1317. doi: 10.1089/neu.2022.0138.
Traumatic brain injury (TBI) remains a leading cause of death and disability worldwide. Motivations for outcome data collection in TBI are threefold: to improve patient outcomes, to facilitate research, and to provide the means and methods for wider injury surveillance. Such data play a pivotal role in population health, and ways to increase the reliability of data collection following TBI should be pursued. As a result, technology-aided follow-up of patients with neurotrauma is on the rise; there is, therefore, a need to describe how such technologies have been used. A scoping review was conducted and reported using the PRISMA extension (PRISMA-ScR). Five electronic databases (Embase, MEDLINE, Global Health, PsycInfo, and Scopus) were searched systematically using keywords derived from the concepts of "telemedicine," "TBI," "outcome assessment," and "patient-generated health data." Forty studies described follow-up technologies (FUTs) utilizing telephones (52.5%, 21), short message service (SMS; 10%, 4), smartphones (22.5%, 9), videoconferencing (10%, 4), digital assistants (2.5%, 1), and custom devices (2.5%, 1) among cohorts of patients with TBI of varying injury severity. Where reported, clinical facilitators, remote follow-up timing and intervals between sessions, synchronicity of follow-up instances, proxy involvement, outcome measures utilized, and technology evaluation efforts are described. FUTs can aid more temporally sensitive assessments and capture fluctuating sequelae, a benefit of particular relevance to TBI cohorts. However, the evidence base surrounding FUTs remains in its infancy, particularly with respect to large samples, low- and middle-income patient cohorts, and the validation of outcome measures for deployment via such remote technology.
创伤性脑损伤(TBI)仍然是全球范围内导致死亡和残疾的主要原因。收集 TBI 结果数据的动机有三:改善患者预后,促进研究,并为更广泛的损伤监测提供手段和方法。这些数据在人群健康中起着关键作用,应该寻求提高 TBI 后数据收集可靠性的方法。因此,神经创伤患者的技术辅助随访正在增加;因此,有必要描述这些技术的使用方法。进行了范围审查,并使用 PRISMA 扩展(PRISMA-ScR)进行了报告。使用源自“远程医疗”、“TBI”、“结果评估”和“患者生成的健康数据”等概念的关键词,系统地搜索了五个电子数据库(Embase、MEDLINE、全球健康、PsycInfo 和 Scopus)。四十项研究描述了使用电话(52.5%,21 项)、短信服务(SMS;10%,4 项)、智能手机(22.5%,9 项)、视频会议(10%,4 项)、数字助理(2.5%,1 项)和定制设备(2.5%,1 项)的 TBI 患者队列中的随访技术(FUTs)。报告中描述了临床促进因素、远程随访时间和会话之间的间隔、随访实例的同步性、代理参与、使用的结果测量以及技术评估工作。FUT 可以帮助进行更具时间敏感性的评估,并捕捉不断变化的后遗症,这对 TBI 队列尤其重要。然而,FUT 的证据基础仍处于起步阶段,特别是在大样本、中低收入患者队列以及通过这种远程技术部署的结果测量的验证方面。