远程牙科应用于健康和教育结果:证据差距图。

Teledentistry Applied to Health and Education Outcomes: Evidence Gap Map.

机构信息

Department of Orthodontics and Pediatric Dentistry, University of São Paulo - School of Dentistry, São Paulo, Brazil.

Latin American and Caribbean Center on Health Sciences Information, São Paulo, Brazil.

出版信息

J Med Internet Res. 2024 Nov 27;26:e60590. doi: 10.2196/60590.

Abstract

BACKGROUND

Teledentistry is a field of activities that comprises information and communication technologies (ICTs) applied to dentistry, including the exchange of clinical information, patient care, and the use of educational strategies across remote distances. Its use has grown progressively over the past decades-intensified by the COVID-19 pandemic-and has been improving the provision of dental services and educational strategies ever since.

OBJECTIVE

This evidence gap map (EGM) study aims to present a collection of systematic reviews (SRs) with meta-analyses to answer the question "What are the applications of teledentistry in dental services and dental education?" by identifying gaps and current evidence on the improvement of health care and education.

METHODS

The EGM methodology has been developed by the Latin American and Caribbean Center on Health Sciences Information and is based on the concept created by the International Initiative for Impact Evaluation. Embase, PubMed, and Virtual Health Library databases were used for the literature research, using terms for teledentistry associated with eHealth, dental education, and oral health care. The data obtained from the included studies were then characterized in a Microsoft Excel spreadsheet, with a matrix containing 8 intervention groups (combined interventions, e-learning and tele-education, teleconsultation and teleservice, telemonitoring, telediagnosis, telescreening, ICTs, and artificial intelligence) and 8 outcome groups (diagnosis accuracy, education and professional training, user behavior, clinical practice, patient-centered outcomes, clinical outcomes, health services management, and access to health services). The quality of the studies was assessed using AMSTAR2 (A Measurement Tool to Assess Systematic Reviews). The visual analytics platform Tableau (Salesforce) was used to graphically display the confidence level, number of reviews, health outcomes, and intervention effects.

RESULTS

The confidence level obtained by the criteria applied was high for 28% (19/68) of the studies, moderate for 6% (4/68), low for 15% (10/68), and critically low for 51% (35/68). Among the interventions, the ICT group stood out with 182 (36.8%) out of 494 associations, followed by interventions with e-learning and tele-education (n=96, 19.4% of associations), telediagnosis (n=67, 13.6%), and combined interventions (n=53, 10.7%). Most of the outcomes were aimed at education and professional training (97/494, 19.6% of associations), patient-centered outcomes (74/494, 15%), and health services management (60/494, 12.1%).

CONCLUSIONS

This EGM presents an overview of the contributions of teledentistry in patient care, health services, clinical practice, and education. The study results may help guide future research and policy decisions and serve as a convenient virtual tool for accessing valuable evidence-based information on teledentistry.

摘要

背景

远程牙科是一个应用信息和通信技术(ICTs)于牙科的活动领域,包括临床信息的交流、患者护理以及远程应用教育策略。在过去几十年中,它的使用逐渐增加——由 COVID-19 大流行加剧——并自此以来一直在改善牙科服务和教育策略的提供。

目的

本证据差距图(EGM)研究旨在展示一系列具有荟萃分析的系统评价(SRs),以回答“远程牙科在牙科服务和牙科教育中有哪些应用?”这一问题,通过确定改善医疗保健和教育方面的差距和现有证据。

方法

EGM 方法由拉丁美洲和加勒比卫生科学信息中心开发,基于国际影响评估倡议创建的概念。使用与远程牙科相关的电子健康、牙科教育和口腔保健的术语,对 Embase、PubMed 和虚拟卫生图书馆数据库进行文献研究。从纳入的研究中获得的数据随后在 Microsoft Excel 电子表格中进行了描述,其中一个矩阵包含 8 个干预组(联合干预、电子学习和远程教育、远程咨询和远程服务、远程监测、远程诊断、远程筛查、信息通信技术和人工智能)和 8 个结果组(诊断准确性、教育和专业培训、用户行为、临床实践、以患者为中心的结果、临床结果、卫生服务管理和获得卫生服务)。使用 AMSTAR2(一种评估系统评价的测量工具)评估研究的质量。使用可视化分析平台 Tableau(Salesforce)以图形方式显示置信水平、综述数量、健康结果和干预效果。

结果

应用标准获得的置信水平高的研究占 28%(68 项中的 19 项),中等的占 6%(68 项中的 4 项),低的占 15%(68 项中的 10 项),临界低的占 51%(68 项中的 35 项)。在干预措施中,信息通信技术组引人注目,有 182 项(494 项关联中的 36.8%),其次是具有电子学习和远程教育的干预措施(n=96,占关联的 19.4%)、远程诊断(n=67,占 13.6%)和联合干预措施(n=53,占 10.7%)。大多数结果旨在教育和专业培训(494 项中的 97 项,占关联的 19.6%)、以患者为中心的结果(494 项中的 74 项,占 15%)和卫生服务管理(494 项中的 60 项,占 12.1%)。

结论

本 EGM 概述了远程牙科在患者护理、卫生服务、临床实践和教育方面的贡献。研究结果可能有助于指导未来的研究和政策决策,并作为获取远程牙科有价值的循证信息的便捷虚拟工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba92/11635335/fa49db930eeb/jmir_v26i1e60590_fig1.jpg

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