远程医疗在新生儿和儿科中的应用。叙述性修订。

Giulio Perrotta
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引用次数: 0

摘要

背景:"远程医疗 "诞生于新的通信技术与传统个人医疗检查模式的结合,从而形成了一种新的服务。方法:选取 PubMed 上截至 2023 年 3 月 30 日的所有临床试验、荟萃分析和随机对照试验,共计 62 项有用研究,进行叙述性修订。结果:在新生儿和儿科领域,远程远程医疗会诊活动(通过短信、电视直播、远程监护、指导和远程保健)在过去十年中有所增加,尤其是在随访方面,在意大利更是如此;然而,这些优势也面临着一些限制:a) 缺乏应用远程医疗工具的技术知识;b) 支持、运行和维护物质工具网络的成本;c) 用户和/或其家人的主观认知扭曲,认为与传统的医疗咨询和提供方法相比,新技术复杂或无用;d) 与远程医疗有关的新技术措施不适用于需要身体接触的就诊情况;e) 大部分已发表的研究报告在研究设计的构建阶段存在结构性错误,导致最终结果无效,如代表性方面的人口样本减少或不足的假设、研究小组设计和使用的特定信息技术工具的宣传方面的利益冲突假设以及统计用途可疑的满意度调查问卷。结论:有重要证据表明,在新生儿科和儿科部门的社会和经济背景下,在医疗服务中使用新的信息技术对确保医疗服务的效率、有效性和质量非常重要,但也存在一些实际的关键问题。
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The The applications of the Telemedicine in Neonatology and Pediatrics. A narrative revision.
BACKGROUND: "Telemedicine" was born from the combination of new communication technologies with traditional personal medical examination modalities, thus configuring a new service. METODOLOGY: All clinical trials, meta-analyses, and randomized controlled trials on PubMed were selected through March 30, 2023, for a useful total of 62 studies, for the purpose of narrative revision. RESULTS: In neonatology and pediatrics, there has been an increase in the last decade, especially in Italy, of remote telemedicine consultation activities (via messaging, televisiting, telemonitoring, coaching, and telehealth), especially in terms of follow-up; however, these the advantages come up against a number of limitations: a) the lack of technical knowledge of the tools used for applied telemedicine; b) the costs of supporting, operating and maintaining the material instrumental network; c) the subjective cognitive distortions of the user and/or his or her family, related to the complication or uselessness of the new technologies compared to traditional methods of health care consultation and delivery; d) the non-applicability of the new technological measures related to telemedicine in the case of medical visits that require physical contact; e) a good part of the published studies have structural errors in the construction phase of the research design, effectively vitiating the final result, as happens in the hypotheses of reduced or insufficient population sample with respect to representativeness, conflict of interest with respect to the hypotheses of publicity of the specific IT tool devised and used by the research team, and satisfaction questionnaires of dubious statistical usefulness. CONCLUSIONS: Significant evidence emerges concerning the importance of using new information technology in the service of medicine, albeit with several practical criticalities, to ensure efficiency, effectiveness, and quality of health service, both concerning social and economic contexts, for Neonatology and Pediatrics departments.  
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