Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
J Eur Acad Dermatol Venereol. 2023 Dec;37(12):2440-2449. doi: 10.1111/jdv.19392. Epub 2023 Aug 16.
Digital health interventions (DHI) potentially improve the efficiency and effectiveness of dermatological care. Currently, an overview clustering and characterizing the evidence on DHIs is missing. This systematic mapping of the literature aims to analyse published research on DHIs in dermatology to identify trends and gaps in research. For this purpose, a systematic search of the MEDLINE database was conducted in August 2022 to identify original publications on DHIs in dermatology. Data on country, targeted audience, DHI category, indication, outcome parameter and study design were extracted. Out of 12,009 records identified in MEDLINE, 403 studies were included in the final analysis. Studies on DHIs mainly performed in western countries, headed by the United States (n = 133), Germany (n = 32) and Spain (n = 23). Of all identified DHIs, 261 targeted healthcare providers (HCP), 66 clients (e.g. patients, caregivers, healthy individuals) and 67 both clients and HCPs. A majority of DHIs focussed on establishing a diagnosis (n = 254). Every other study analysed store-and-forward teledermatology (n = 187), followed by artificial intelligence applications for image analysis (n = 65). The most often analysed DHI category for clients was a support of health behaviour change (n = 31). Monitoring of clients was targeted by 77 studies. Skin cancer (n = 148), wounds (n = 29) and psoriasis (n = 29) were the most targeted indications by DHIs. Most studies analysed diagnostic performance (n = 166), fewer studies analysed acceptance (n = 92) and effectiveness (n = 98). Usability (n = 32) and efficiency (n = 36) were investigated only to a small extent. Studies on DHIs in dermatology have focused on teledermatology and AI applications, with an emphasis on skin cancer diagnosis. Apart from that, a range of DHIs for different user groups, purposes and indications were identified, demonstrating the broad potential for DHIs in dermatology. Further research with a wider set of outcome parameters is needed to fully understand the potential of DHIs and ensure their sustainable implementation into dermatological care.
数字健康干预（DHI）有可能提高皮肤病学护理的效率和效果。目前，缺乏对 DHI 证据的概述和特征描述。本系统文献综述旨在分析皮肤病学中 DHI 的已发表研究，以确定研究中的趋势和差距。为此，于 2022 年 8 月在 MEDLINE 数据库中进行了系统检索，以确定皮肤病学中 DHI 的原始出版物。提取了有关国家、目标受众、DHI 类别、适应证、结局参数和研究设计的数据。在 MEDLINE 中确定的 12009 条记录中，有 403 项研究纳入最终分析。DHI 的研究主要在西方国家进行，其中美国（n=133）、德国（n=32）和西班牙（n=23）位居前列。在所确定的所有 DHI 中，261 项针对医疗保健提供者（HCP），66 项针对客户（如患者、护理人员、健康个体），67 项针对 HCP 和客户。大多数 DHI 侧重于建立诊断（n=254）。其他每一项研究都分析了存储转发远程皮肤病学（n=187），其次是用于图像分析的人工智能应用（n=65）。针对客户的最常用 DHI 类别是支持健康行为改变（n=31）。有 77 项研究针对客户监测。皮肤癌（n=148）、伤口（n=29）和银屑病（n=29）是 DHI 最针对的适应证。大多数研究分析了诊断性能（n=166），较少的研究分析了接受度（n=92）和有效性（n=98）。仅在较小程度上研究了可用性（n=32）和效率（n=36）。皮肤病学中的 DHI 研究主要集中在远程皮肤病学和人工智能应用上，重点是皮肤癌诊断。除此之外，还确定了针对不同用户群体、目的和适应证的各种 DHI，展示了 DHI 在皮肤病学中的广泛潜力。需要进一步开展研究，增加更多的结局参数，以充分了解 DHI 的潜力，并确保其可持续应用于皮肤病学护理。
