Tong Shuk Y K, Jackson Tim M, Lau Annie Y S
Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, L6, Macquarie Park, New South Wales 2113, Australia.
Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, L6, Macquarie Park, New South Wales 2113, Australia.
Int J Med Inform. 2024 Nov;191:105561. doi: 10.1016/j.ijmedinf.2024.105561. Epub 2024 Jul 26.
The conduct of virtual physical examination has provided significant information for the diagnosis during a teleconsultation session, especially during the COVID-19 pandemic, where in-person physical examinations have been greatly compromised.
The aim of this scoping review was to provide a comprehensive overview of the available evidence concerning virtual physical examination (VPE) in all healthcare settings during the COVID-19 pandemic. The review focuses on types of VPE, technological and non-technological approaches, patient and clinician experiences, as well as barriers and facilitators of VPE.
A literature search was conducted across three databases, namely MEDLINE, Embase, and Scopus. Only studies in the English language with primary research data collected from December 2019 to January 2023 were included. A narrative analysis, highlighting patients' and clinicians' experiences, was conducted on the included studies. This scoping review was reported using The PRISMA extension for scoping reviews (PRISMA-ScR) Checklist.
A total of 25 articles meeting eligibility criteria were identified. Three major types of VPE included were musculoskeletal, head and neck, and chest exams. Sixteen studies involved specific technological aids, while three studies involved non-technological aids. Patients found VPE helped them to better assess their disease conditions, or aided their clinicians' understanding of their conditions. Clinicians also reported that VPE had provided enough clinically relevant information for decision-making in 2 neurological evaluations. Barriers to conducting VPE included technological challenges, efficacy concerns, confidence level of assistants, as well as patient health conditions, health literacy, safety, and privacy.
Patients found virtual physical examination (VPE) helpful in understanding their own conditions, and clinicians found it useful for better assessing patient's conditions. From the clinicians' point of view, VPE provided sufficient clinically relevant information for decision-making in neurological evaluations. Major barriers identified for VPE included technological issues, patient's health conditions, and their health literacy.
虚拟体格检查的实施在远程会诊期间为诊断提供了重要信息，尤其是在2019冠状病毒病大流行期间，面对面体格检查受到了极大影响。
本综述的目的是全面概述2019冠状病毒病大流行期间所有医疗环境中有关虚拟体格检查（VPE）的现有证据。该综述聚焦于VPE的类型、技术和非技术方法、患者和临床医生的体验，以及VPE的障碍和促进因素。
在三个数据库，即医学期刊数据库（MEDLINE）、荷兰医学文摘数据库（Embase）和Scopus中进行文献检索。仅纳入从2019年12月至2023年1月收集了原始研究数据的英文研究。对纳入研究进行了叙述性分析，突出患者和临床医生的体验。本综述使用《系统评价和Meta分析扩展版报告清单》（PRISMA-ScR）进行报告。
共识别出25篇符合纳入标准的文章。纳入的VPE主要有三种类型，包括肌肉骨骼检查、头颈部检查和胸部检查。16项研究涉及特定的技术辅助工具，3项研究涉及非技术辅助工具。患者发现VPE有助于他们更好地评估自身病情，或有助于临床医生了解他们的病情。临床医生还报告说，VPE在2项神经学评估中提供了足够的临床相关信息用于决策。进行VPE的障碍包括技术挑战、对疗效的担忧、助手的信心水平，以及患者的健康状况、健康素养、安全性和隐私。
患者发现虚拟体格检查（VPE）有助于了解自身病情，临床医生发现它有助于更好地评估患者病情。从临床医生的角度来看，VPE为神经学评估中的决策提供了足够的临床相关信息。确定的VPE主要障碍包括技术问题、患者的健康状况及其健康素养。
