Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College, suite 500, Montreal, QC, Canada.
Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada.
Syst Rev. 2022 Oct 29;11(1):234. doi: 10.1186/s13643-022-02103-2.
During the past decade e-oral health technology has been used to address the oral health care challenges in rural and remote settings. This review systematically evaluated the literature on patient satisfaction with e-oral health care in rural and remote communities.
The systematic review included interventional and observational studies published between 1946 and 2021, in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Global Health. Patient satisfaction with received oral health care using self-reported measures, at any time after the intervention, was the main outcome of the review. The other primary outcomes were undesirable consequences of the health care (e-health or conventional) such as diagnostic error. The secondary outcomes considered were waiting time, number of visits, travel, and the cost of oral health care. Two independent researchers assessed the risk of bias using the ROBINS-I risk of bias assessment tool for non-randomized studies.
Among 898 studies, 16 studies were included in the review. In most studies reporting patient satisfaction, all patients had shown willingness for teleconsultation for a dental problem and they were mostly satisfied due to saved travel time, saved working days, and prompt treatment onset. Most of the studies acknowledged teledentistry as a cost-effective and cost-saving method. Moreover, the teledentistry consultations showed diagnostic reliability and validity values comparable to conventional dental consultations. The majority of studies were considered level 4 and 3b, due to limited sample populations, analysis based on limited alternatives or costs, non-consistent sensitivity analysis, failure to appropriately control known confounders, and/or failure to carry out an appropriate follow-up of patients.
Available evidence indicates that e-oral health is associated with higher patient satisfaction and has been found to be an effective and reliable method for patients in rural and remote areas. Therefore, in these areas, the use of e-oral health should be encouraged. However, methodological inconsistencies in the current evidence suggest the need for long-term cohort studies and clinical trials, as well as cost analysis on e-oral health in rural settings.
The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42016039942.
在过去的十年中，电子口腔健康技术已被用于解决农村和偏远地区的口腔保健挑战。本综述系统地评估了关于农村和偏远社区中患者对电子口腔保健满意度的文献。
该系统评价包括 1946 年至 2021 年间发表的干预性和观察性研究，纳入 Cochrane 对照试验中心注册库、MEDLINE、EMBASE 和全球卫生。使用自我报告措施评估患者对接受的口腔保健的满意度是本综述的主要结局，干预后任何时间报告的满意度。主要的次要结局是保健（电子或常规）的不良后果，如诊断错误。考虑的次要结局包括等待时间、就诊次数、旅行和口腔保健的费用。两名独立的研究人员使用 ROBINS-I 非随机研究的偏倚风险评估工具评估偏倚风险。
在 898 项研究中，有 16 项研究纳入了综述。在大多数报告患者满意度的研究中，所有患者都表现出愿意通过远程咨询解决牙科问题，他们主要是因为节省了旅行时间、工作时间和及时开始治疗而感到满意。大多数研究认为远程牙科是一种具有成本效益和节省成本的方法。此外，远程牙科咨询显示出与传统牙科咨询相当的诊断可靠性和有效性值。由于样本量有限、基于有限替代方案或成本的分析、不一致的敏感性分析、未能适当控制已知混杂因素以及/或未能对患者进行适当的随访，大多数研究被认为是 4 级和 3b 级。
现有证据表明，电子口腔健康与更高的患者满意度相关，并已被证明是农村和偏远地区患者的有效可靠方法。因此，应鼓励在这些地区使用电子口腔健康。然而，当前证据中的方法学不一致表明需要进行长期队列研究和临床试验，以及对农村地区电子口腔健康的成本分析。
系统评价方案在国际前瞻性系统评价注册库（PROSPERO）中以 CRD42016039942 号注册。
