Lunova Tetiana, Kirk Ulrik Bak, Greenfield Geva, Rochfort Andrée, Darzi Ara, Neves Ana Luisa
NWL Patient Safety Research Collaboration, Institute of Global Health Innovation, Imperial College London, London, United Kingdom.
Department of Public Health, Aarhus University, Aarhus, Denmark.
PLoS One. 2025 Jan 9;20(1):e0313639. doi: 10.1371/journal.pone.0313639. eCollection 2025.
Virtual consultations are being increasingly incorporated into routine primary care, as they offer better time and geographical flexibility for patients while also being cost-effective for both patients and service providers. At the same time, concerns have been raised about the extent to which virtual care is safe for patients. As of now, there is no validated methodology for evaluating the safety nuances and implications of virtual care. This study aims to identify patient safety indicators that could be used to evaluate the safety of virtual consultations in primary care.
A literature search will be performed in Ovid MEDLINE/PubMed, Embase, and Cochrane Library for relevant articles published over the last 10 years (2014-2024). The systematic review will include randomized and non-randomized controlled trials and observational studies with adult populations that compare synchronous patient-provider virtual consultations (telephone or video) or multicomponent interventions involving synchronous remote consultations with face-to-face consultations. The outcome of interest will be patient safety indicators extracted from the studies. The quality of randomized controlled trials will be assessed with the Cochrane Risk of Bias Tool, and the Newcastle-Ottawa Scale will be used to analyze risk of bias in observational studies.
Considering the growing adoption of virtual medical care worldwide, a robust and comprehensive evaluation of its safety and quality is now a system-wide priority. Therefore, one of the primary strengths of this proposed systematic review is its focus on a topic of great importance and timeliness, specifically addressing the existing knowledge gap in this area. By publishing this protocol, we demonstrate the transparency and reliability of our research strategy and aim to minimize the risk of selection bias. Potential limitations include the heterogeneity of measures and outcomes, as well as a lower-than-expected number of studies in subgroup analyses, which may negatively influence the statistical significance in data synthesis.
PROSPERO registration number: CRD42023464878.
虚拟会诊正越来越多地融入到常规初级医疗中，因为它们为患者提供了更好的时间和地理灵活性，同时对患者和服务提供者来说都具有成本效益。与此同时，人们对虚拟医疗对患者的安全程度提出了担忧。截至目前，尚无经过验证的方法来评估虚拟医疗的安全细微差别和影响。本研究旨在确定可用于评估初级医疗中虚拟会诊安全性的患者安全指标。
将在Ovid MEDLINE/PubMed、Embase和Cochrane图书馆中检索过去10年（2014 - 2024年）发表的相关文章。系统评价将包括随机和非随机对照试验以及针对成年人群的观察性研究，这些研究比较同步的医患虚拟会诊（电话或视频）或涉及同步远程会诊与面对面会诊的多成分干预措施。感兴趣的结果将是从研究中提取的患者安全指标。随机对照试验的质量将使用Cochrane偏倚风险工具进行评估，纽卡斯尔 - 渥太华量表将用于分析观察性研究中的偏倚风险。
鉴于全球范围内虚拟医疗的使用日益增加，对其安全性和质量进行强有力且全面的评估现在是全系统的优先事项。因此，本拟议系统评价的主要优势之一在于其专注于一个极其重要且具有时效性的主题，特别解决了该领域现有的知识空白。通过发布本方案，我们展示了研究策略的透明度和可靠性，并旨在将选择偏倚的风险降至最低。潜在的局限性包括测量方法和结果的异质性以及亚组分析中研究数量低于预期，这可能会对数据合成中的统计学显著性产生负面影响。
PROSPERO注册号：CRD42023464878。
