Canary Islands Health Research Institute Foundation (FIISC), 38320 Tenerife, Spain.
Evaluation Unit of the Canary Islands Health Service (SESCS), 38109 Tenerife, Spain.
Int J Environ Res Public Health. 2023 Feb 19;20(4):3694. doi: 10.3390/ijerph20043694.
Neurological disorders are the leading cause of disability and the second leading cause of death worldwide. Teleneurology (TN) allows neurology to be applied when the doctor and patient are not present in the same place, and sometimes not at the same time. In February 2021, the Spanish Ministry of Health requested a health technology assessment report on the implementation of TN as a complement to face-to-face neurological care.
A scoping review was conducted to answer the question on the ethical, legal, social, organisational, patient (ELSI) and environmental impact of TN. The assessment of these aspects was carried out by adapting the EUnetHTA Core Model 3.0 framework, the criteria established by the Spanish Network of Health Technology Assessment Agencies and the analysis criteria of the European Validate (VALues In Doing Assessments of healthcare TEchnologies) project. Key stakeholders were invited to discuss their concerns about TN in an online meeting. Subsequently, the following electronic databases were consulted from 2016 to 10 June 2021: MEDLINE and EMBASE.
79 studies met the inclusion criteria. This scoping review includes 37 studies related to acceptability and equity, 15 studies developed during COVID and 1 study on environmental aspects. Overall, the reported results reaffirm the necessary complementarity of TN with the usual face-to-face care.
This need for complementarity relates to factors such as acceptability, feasibility, risk of dehumanisation and aspects related to privacy and the confidentiality of sensitive data.
神经疾病是全球范围内导致残疾和死亡的主要原因。远程神经医学（Teleneurology，TN）允许在医生和患者不在同一地点甚至不同时间的情况下应用神经医学。2021 年 2 月，西班牙卫生部要求进行一项关于实施 TN 作为面对面神经护理补充的卫生技术评估报告。
进行了一次范围综述，以回答关于 TN 的伦理、法律、社会、组织、患者（ELSI）和环境影响的问题。这些方面的评估是通过适应欧盟网络卫生技术评估机构的核心模型 3.0 框架、西班牙卫生技术评估机构网络制定的标准以及欧洲 Validate（VALues In Doing Assessments of healthcare TEchnologies）项目的分析标准来进行的。关键利益相关者应邀在一次在线会议上讨论他们对 TN 的关注。随后，从 2016 年至 2021 年 6 月 10 日，查阅了以下电子数据库：MEDLINE 和 EMBASE。
符合纳入标准的研究有 79 项。本范围综述包括 37 项与可接受性和公平性相关的研究、15 项在 COVID 期间开展的研究和 1 项关于环境方面的研究。总体而言，报告的结果再次证实了 TN 与通常的面对面护理的必要互补性。
这种互补性的需求涉及可接受性、可行性、去人性化风险以及与隐私和敏感数据保密性相关的方面等因素。
