Scheerman Janneke F M, Qari Alaa H, Varenne Benoit, Bijwaard Harmen, Swinckels Laura, Giraudeau Nicolas, van Meijel Berno, Mariño Rodrigo
Oral Hygiene, Cluster Health, Sport and Welfare, Inholland University of Applied Sciences, 1081 LA Amsterdam, The Netherlands.
Medical Technology Research Group, Cluster Health, Sport and Welfare, Inholland University of Applied Sciences, 2015 CE Haarlem, The Netherlands.
Int J Environ Res Public Health. 2024 Mar 28;21(4):407. doi: 10.3390/ijerph21040407.
Teledentistry offers possibilities for improving efficiency and quality of care and supporting cost-effective healthcare systems. This umbrella review aims to synthesize existing systematic reviews on teledentistry and provide a summary of evidence of its clinical- and cost-effectiveness. A comprehensive search strategy involving various teledentistry-related terms, across seven databases, was conducted. Articles published until 24 April 2023 were considered. Two researchers independently reviewed titles, abstracts and full-text articles. The quality of the included reviews was critically appraised with the AMSTAR-2 checklist. Out of 749 studies identified, 10 were included in this umbrella review. Two reviews focusing on oral-health outcomes revealed that, despite positive findings, there is not yet enough evidence for the long-term clinical effectiveness of teledentistry. Ten reviews reported on economic evaluations or costs, indicating that teledentistry is cost-saving. However, these conclusions were based on assumptions due to insufficient evidence on cost-effectiveness. The main limitation of our umbrella review was the critically low quality of the included reviews according to AMSTAR-2 criteria, with many of these reviews basing their conclusions on low-quality studies. This highlights the need for high-quality experimental studies (e.g., RCTs, factorial designs, stepped-wedge designs, SMARTs and MRTs) to assess teledentistry's clinical- and cost-effectiveness.
远程牙科为提高医疗效率和质量以及支持具有成本效益的医疗系统提供了可能性。本综述旨在综合现有的关于远程牙科的系统评价,并总结其临床和成本效益的证据。我们采用了全面的检索策略,涉及七个数据库中的各种与远程牙科相关的术语,检索截至2023年4月24日发表的文章。两名研究人员独立审查了标题、摘要和全文文章。使用AMSTAR-2清单对纳入评价的质量进行了严格评估。在识别出的749项研究中,有10项纳入了本综述。两项关注口腔健康结果的评价显示,尽管有积极的发现,但尚无足够证据证明远程牙科的长期临床有效性。十项评价报告了经济评估或成本,表明远程牙科具有成本节约作用。然而,由于成本效益方面的证据不足,这些结论是基于假设得出的。根据AMSTAR-2标准,我们的综述的主要局限性在于纳入评价的质量极低,其中许多评价的结论基于低质量研究。这凸显了需要高质量的实验研究(如随机对照试验、析因设计、阶梯楔形设计、序贯多重分配随机试验和多区域试验)来评估远程牙科的临床和成本效益。