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移动医疗和远程医疗技术在肾结石管理和预防中的应用:系统评价。

Mobile and eHealth technologies in the management and prevention of nephrolithiasis: A systematic review.

作者信息

Ungerer G N, Winoker J S, Healy K A, Shah O, Koo K

机构信息

Department of Urology, Mayo Clinic, Rochester, MN, USA.

Smith Institute for Urology at Lenox Hill, Northwell Health, New York, NY, USA.

出版信息

Actas Urol Esp (Engl Ed). 2024 Jan-Feb;48(1):25-41. doi: 10.1016/j.acuroe.2023.06.010. Epub 2023 Jun 25.

Abstract

INTRODUCTION

Kidney stone disease (KSD) is a common urological condition that often requires long-term care. Mobile health (mHealth) and eHealth technologies have the potential to enhance chronic disease management and behavioral change. To assess opportunities to apply these tools to improve KSD treatment and prevention, we aimed to assess current evidence on the use, benefits, and limitations of mHealth and eHealth in KSD.

METHODS

We performed a systematic review of primary research studies of mHealth and eHealth in the evaluation and management of KSD. Two independent researchers screened citations by title and abstract for relevance, then full-text review was performed for descriptive summary of the studies.

RESULTS

A total of 37 articles were included for analysis. Primary domains of evidence included: 1) "smart" water bottles and mobile-device apps for tracking fluid consumption, which showed increased intake in most studies; 2) ureteral stent tracking platforms, which improved the rate of long-term retained stents; 3) virtual stone clinics, which have been suggested to increase access, lower costs, and have satisfactory outcomes; 4) smartphone-based endoscopy platforms, which offered cost-effective image quality in resource-limited settings; 5) patient information about KSD online, which was typically characterized as poor quality and/or accuracy, particularly on YouTube. Most studies were proof-of-concept or single-arm intervention designs, with limited assessment of effectiveness or long-term clinical outcomes.

CONCLUSIONS

Mobile and eHealth technologies have significant real-world applications to KSD prevention, intervention, and patient education. A lack of rigorous effectiveness studies currently limits evidence-based conclusions and incorporation in clinical guidelines.

摘要

简介

肾结石病(KSD)是一种常见的泌尿科疾病,通常需要长期护理。移动健康(mHealth)和电子健康(eHealth)技术有潜力增强慢性病管理和行为改变。为了评估将这些工具应用于改善 KSD 治疗和预防的机会,我们旨在评估 mHealth 和 eHealth 在 KSD 评估和管理中应用的当前证据,包括使用情况、益处和局限性。

方法

我们对 mHealth 和 eHealth 在 KSD 评估和管理中的应用进行了系统的文献综述。两名独立的研究人员根据标题和摘要对参考文献进行了相关性筛选,然后对全文进行了审查,以对研究进行描述性总结。

结果

共有 37 篇文章被纳入分析。主要的证据领域包括:1)用于跟踪液体摄入量的“智能”水瓶和移动设备应用程序,大多数研究显示摄入量增加;2)输尿管支架跟踪平台,提高了长期留置支架的比例;3)虚拟结石诊所,被认为可以增加获得途径、降低成本,且具有令人满意的结果;4)基于智能手机的内窥镜平台,在资源有限的环境下提供了具有成本效益的图像质量;5)KSD 患者在线信息,通常质量较差且/或准确性较差,尤其是在 YouTube 上。大多数研究都是概念验证或单臂干预设计,对有效性或长期临床结果的评估有限。

结论

移动和电子健康技术在 KSD 的预防、干预和患者教育方面具有重要的实际应用。目前,缺乏严格的有效性研究限制了基于证据的结论和纳入临床指南。

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