Carolina Dutra Queiroz Flumignan1, Aline Pereira da Rocha2, Ana Carolina Pereira Nunes Pinto3, Keilla Machado Martins Milby4, Mayara Rodrigues Batista5, Álvaro Nagib Atallah6, Humberto Saconato7. 1. MD, PhD. Postdoctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), and Volunteer Researcher, Cochrane Brazil, São Paulo (SP), Brazil. 2. MSc. Pharmacist and Doctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), and Volunteer Researcher, Cochrane Brazil, São Paulo (SP), Brazil. 3. MSc. Physiotherapist and Doctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP); Professor, Department of Biological and Health Sciences, Universidade Federal do Amapá, Macapá (AP); and Volunteer Researcher, Cochrane Brazil, São Paulo (SP), Brazil. 4. BSc. Nurse and Doctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), and Volunteer Researcher, Cochrane Brazil, São Paulo (SP), Brazil. 5. BSc. Librarian and Doctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), and Volunteer Researcher, Cochrane Brazil, São Paulo (SP), Brazil. 6. MD, MSc, PhD. Nephrologist and Full Professor, Discipline of Emergency and Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), and Director, Cochrane Brazil, São Paulo (SP), Brazil. 7. MD, PhD. Adjunct Professor, Discipline of Emergency and Evidence-Based Medicine, Universidade Federal de São Paulo (UNIFESP), and Researcher, Cochrane Brazil, São Paulo (SP), Brazil.
Abstract
BACKGROUND: Telemedicine has emerged as a tool for overcoming the challenges of healthcare systems and is likely to become increasingly viable, since information and communication technologies have become more sophisticated and user-friendly. OBJECTIVE: We aimed to identify all Cochrane systematic reviews (CSRs) on telemedicine within healthcare and to summarize the current evidence regarding its use. DESIGN AND SETTING: Review of CSRs, developed at the Discipline of Emergency and Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: We searched for studies that compared use of telemedicine with conventional treatment or management of diseases within healthcare. Diagnostic telemedicine studies or studies using automatic text, voice-text or even self-managed care were excluded. The main characteristics and the certainty of evidence were synthetized and critically discussed by all authors. RESULTS: We included 10 CSRs that investigated a broad range of diseases. There is still insufficient evidence to determine what types of telemedicine interventions are effective, for which patients and in which settings, and whether such interventions can be used as a replacement for the standard treatment. Harm relating to telemedicine technologies needs to be better investigated and addressed. CONCLUSION: Telemedicine might be an excellent way to facilitate access to treatment, monitoring and dissemination of important clinical knowledge. However, given the recognition of systematic reviews as the best evidence resource available for decision-making, further randomized controlled trials with stricter methods are necessary to reduce the uncertainties in evidence-based use of telemedicine.
BACKGROUND: Telemedicine has emerged as a tool for overcoming the challenges of healthcare systems and is likely to become increasingly viable, since information and communication technologies have become more sophisticated and user-friendly. OBJECTIVE: We aimed to identify all Cochrane systematic reviews (CSRs) on telemedicine within healthcare and to summarize the current evidence regarding its use. DESIGN AND SETTING: Review of CSRs, developed at the Discipline of Emergency and Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: We searched for studies that compared use of telemedicine with conventional treatment or management of diseases within healthcare. Diagnostic telemedicine studies or studies using automatic text, voice-text or even self-managed care were excluded. The main characteristics and the certainty of evidence were synthetized and critically discussed by all authors. RESULTS: We included 10 CSRs that investigated a broad range of diseases. There is still insufficient evidence to determine what types of telemedicine interventions are effective, for which patients and in which settings, and whether such interventions can be used as a replacement for the standard treatment. Harm relating to telemedicine technologies needs to be better investigated and addressed. CONCLUSION: Telemedicine might be an excellent way to facilitate access to treatment, monitoring and dissemination of important clinical knowledge. However, given the recognition of systematic reviews as the best evidence resource available for decision-making, further randomized controlled trials with stricter methods are necessary to reduce the uncertainties in evidence-based use of telemedicine.
Authors: Jacqueline Do; Nathan Phan; Daniel L Solomon; Elyssa Y Wong; Cria-May M Khong; Elizabeth C Pasipanodya; Benjamin Dirlikov; Kazuko Shem Journal: Spinal Cord Date: 2022-03-28 Impact factor: 2.473