杂志文章Gunther Eysenbach远程会诊和视频会议对糖尿病护理的贡献:系统文献综述%A Verhoeven,Fenne %A van Gemert-Pijnen,Lisette %A Dijkstra,Karin %A Nijland,Nicol %A Seydel,Erwin %A stehouder,Michaël %+特温特大学技术与专业传播系，行为科学学院，邮政邮箱217,7500 AE Enschede，荷兰，+31 53 489 4441，f.verhoeven@utwente.nl %K慢性疾病%K糖尿病%K远程医疗%K会诊%K远程会诊%K视频会议%D 2007 %7 14.12.2007 %9综述%J J医学互联网Res %G英文%X背景:对远程会诊和视频会议在糖尿病多方面护理过程中的益处进行了系统的文献综述。以前的评论主要关注技术的可用性，考虑的主要是片面的干预。目的:目的是确定远程会诊和视频会议在糖尿病护理的临床、行为和护理协调结果方面的优点和不足。方法:检索相关出版物的电子数据库(Medline、PiCarta、psyinfo、ScienceDirect、Telemedicine Information Exchange、ISI Web of Science、谷歌Scholar)。从临床结果(如糖化血红蛋白、血压、生活质量)、行为结果(患者与护理人员的互动、自我护理)和护理协调结果(技术的可用性、成本效益、指南的透明度、护理获得的公平性)来检查对糖尿病护理的贡献。采用标准的meta分析方法汇总以HbA1c为结果的随机对照试验(rct)。结果:在识别的852份出版物中，39份符合护理人员与1型、2型或妊娠期糖尿病患者(组)之间电子通信的纳入标准。评估不特别针对糖尿病的远程会诊或视频会议的研究被排除在外，那些描述仅针对临床改善的干预措施的研究也被排除在外(如HbA1c)。 There were 22 interventions related to teleconsultation, 13 to videoconferencing, and 4 to combined teleconsultation and videoconferencing. The heterogeneous nature of the identified videoconferencing studies did not permit a formal meta-analysis. Pooled results from the six RCTs of the identified teleconsultation studies did not show a significant reduction in HbA1c (0.03%, 95% CI = - 0.31% to 0.24%) compared to usual care. There was no significant statistical heterogeneity among the pooled RCTs (χ27= 7.99, P = .33). It can be concluded that in the period under review (1994-2006) 39 studies had a scope broader than clinical outcomes and involved interventions allowing patient-caregiver interaction. Most of the reported improvements concerned satisfaction with technology (26/39 studies), improved metabolic control (21/39), and cost reductions (16/39). Improvements in quality of life (6/39 studies), transparency (5/39), and better access to care (4/39) were hardly observed. Teleconsultation programs involving daily monitoring of clinical data, education, and personal feedback proved to be most successful in realizing behavioral change and reducing costs. The benefits of videoconferencing were mainly related to its effects on socioeconomic factors such as education and cost reduction, but also on monitoring disease. Additionally, videoconferencing seemed to maintain quality of care while producing cost savings. Conclusions: The selected studies suggest that both teleconsultation and videoconferencing are practical, cost-effective, and reliable ways of delivering a worthwhile health care service to diabetics. However, the diversity in study design and reported findings makes a strong conclusion premature. To further the contribution of technology to diabetes care, interactive systems should be developed that integrate monitoring and personalized feedback functions. %M 18093904 %R 10.2196/jmir.9.5.e37 %U //www.mybigtv.com/2007/5/e37/ %U https://doi.org/10.2196/jmir.9.5.e37 %U http://www.ncbi.nlm.nih.gov/pubmed/18093904