Statens beredning för medicinsk och social utvärdering
Specialiserad neonatalvård via telemedicin
Tillgången till neonatal intensivvård varierar över landet. Digitala kanaler skulle kunna bidra till ökad tillgång av specialistkonsultation regionalt. Det är dock oklart om effekten av konsultation och rondning via telemedicin genom till exempel videolänk skiljer sig från effekten av ett fysiskt möte.
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Fråga till SBU:s upplysningstjänst
Vilka vetenskapliga studier finns om effekter och risker med specialiserad neonatalvård via telemedicin?
Frågeställare: Överläkare, Region Gävleborg
Sammanfattning SBU:s upplysningstjänst
På SBU:s upplysningstjänst identifierar och redovisar vi sammanställd forskning (systematiska översikter) eller identifierar vetenskapliga studier som svar på en avgränsad fråga. Vi bedömer risken för bias (överskattning eller underskattning av resultat) i systematiska översikter och presenterar författarnas slutsatser från systematiska översikter med låg eller måttlig risk för bias. I vetenskapliga primärstudier bedömer vi inte risken för bias och därför presenteras de bara som referenser. Vid behov bedömer vi kvalitet avseende ekonomiska aspekter och överförbarhet av resultat i hälsoekonomiska studier och presenterar författarnas slutsatser från de studier som bedöms ha tillräcklig kvalitet. I svaren väger vi inte samman resultaten eller bedömer graden av vetenskaplig tillförlitlighet.
SBU:s upplysningstjänst har efter litteratursökning och kvalitetsgranskning av systematiska översikter inte inkluderat någon systematisk översikt i svaret. Det har dock identifierats en relevant systematisk översikt som undersökt telemedicin inom neonatal och pediatrisk vård och där vi har bedömt att risken för systematiska fel är hög. SBU:s upplysningstjänst har identifierat elva primärstudier, vilka inte har kvalitetsgranskats. Författarnas slutsatser presenteras därför inte här.
Litteratursökning
| The search result, usually found at the end of the documentation, forms the list of abstracts. [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | ("Infant, Newborn"[Mesh]) OR "Premature Birth"[Mesh] | 594 549 |
| 2. | (preterm[tiab] OR newborn[tiab] OR neonat*[tiab] OR prematur*[tiab]) | 501 829 |
| 3. | 1 OR 2 | 859 454 |
| Intervention: | ||
| 4. | ("Telemedicine"[Mesh]) | 25 805 |
| 5. | remote[tiab] OR NTH[tiab] OR telemedicine[tiab] OR tele-care[tiab] OR tele-homecare[tiab] OR "tele care"[tiab] OR "tele home care"[tiab] OR telephone[tiab] OR video[tiab] OR smartphone[tiab] NOT medline[sb] | 39 948 |
| 6. | 4 OR 5 | 68 461 |
| Final | 3 AND 6 | 1 182 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | NICU[tiab] | 9 328 |
| Intervention: | ||
| 2. | ("Telemedicine"[Mesh]) | 26 121 |
| 3. | (remote[tiab] OR NTH[tiab] OR telemedicine[tiab] OR tele-care[tiab] OR tele-homecare[tiab] OR "tele care"[tiab] OR "tele home care"[tiab] OR telephone[tiab] OR video[tiab] OR smartphone[tiab] OR webcam[tiab] OR web-cam[tiab]) NOT medline[sb] | 40 355 |
| 4. | 2 OR 3 | 66 476 |
| Final | 1 AND 4 | 73 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | ("Infant, Newborn"[Mesh]) OR "Premature Birth"[Mesh] | 596 875 |
| 2. | (preterm[tiab] OR newborn[tiab] OR neonat*[tiab] OR prematur*[tiab] OR NICU[tiab]) | 505 263 |
| 3. | 1 OR 2 | 863 586 |
| Intervention: | ||
| 4. | (webcam[tiab] OR web-cam[tiab]) | 317 |
| Final | 1 AND 4 | 6 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; au = Author; MeSH = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = Title; :ab = Abstract; :kw = Keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; CDSR = Cochrane Database of Systematic Review; CENTRAL = Cochrane Central Register of Controlled Trials, “trials”; CRM = Method Studies; DARE = Database Abstracts of Reviews of Effects, “other reviews”; EED = Economic Evaluations; HTA = Health Technology Assessments | ||
| Search terms | Items found | |
| Population: | ||
| 1. | MeSH descriptor: [Infant, Newborn] explode all trees | 15243 |
| 2. | MeSH descriptor: [Premature Birth] explode all trees | 1155 |
| 3. | (preterm):ti,ab,kw OR (neonat*):ti,ab,kw OR (Newborn):ti,ab,kw OR (prematur*):ti,ab,kw (Word variations have been searched) | 49519 |
| 4. | 1 OR 2 OR 3 | |
| Intervention: | ||
| 5. | MeSH descriptor: [Telemedicine] explode all trees | 2174 |
| 6. | (remote):ti,ab,kw OR (telemedicine):ti,ab,kw OR (tele-care):ti,ab,kw OR ("tele care"):ti,ab,kw OR ("tele homecare"):ti,ab,kw (Word variations have been searched) | 7 696 |
| 7. | ("tele-homecare"):ti,ab,kw OR (video):ti,ab,kw OR (telephone):ti,ab,kw OR (smartphone):ti,ab,kw (Word variations have been searched) | 32949 |
| 8. | 5 OR 6 OR 7 | |
| Final | 4 AND 8 | 1250 CDSR/29 CENTRAL/1220 |
| /de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | 'newborn'/exp OR 'child, newborn':ti,ab OR 'full term infant':ti,ab OR 'human neonate':ti,ab OR 'human newborn':ti,ab OR 'infant, newborn':ti,ab OR 'neonate':ti,ab OR 'neonatus':ti,ab OR 'newborn':ti,ab OR 'newborn baby':ti,ab OR 'newborn child':ti,ab OR 'newborn infant':ti,ab OR 'newly born baby':ti,ab OR 'newly born child':ti,ab OR 'newly born infant':ti,ab OR 'prematurity'/exp OR 'infant, extremely premature':ti,ab OR 'infant, premature':ti,ab OR 'infant, premature, diseases':ti,ab OR 'neonate, premature':ti,ab OR 'pre-mature infant':ti,ab OR 'pre-term baby':ti,ab OR 'pre-term child':ti,ab OR 'pre-term infant':ti,ab OR 'pre-term neonate':ti,ab OR 'pre-term newborn':ti,ab OR 'premature':ti,ab OR 'premature baby':ti,ab OR 'premature birth':ti,ab OR 'premature child':ti,ab OR 'premature childbirth':ti,ab OR 'premature infant':ti,ab OR 'premature neonate':ti,ab OR 'premature newborn':ti,ab OR 'premature syndrome':ti,ab OR 'prematuritas':ti,ab OR 'prematurity':ti,ab OR 'preterm baby':ti,ab OR 'preterm child':ti,ab OR 'preterm infant':ti,ab OR 'preterm neonate':ti,ab OR 'preterm newborn':ti,ab OR 'NICU':ti,ab | 803 011 |
| Intervention: | ||
| 2. | 'telemedicine'/exp OR 'tele medicine':ti,ab OR 'telemedicine':ti,ab OR 'teleconsultation'/exp OR 'remote consultation':ti,ab OR 'tele-consultation':ti,ab OR 'teleconsultation':ti,ab OR 'telephone consultation':ti,ab OR 'tele homecare':ti,ab OR 'tele care':ti,ab | 38 582 |
| Final | 1 AND 2 | 787 |
| /de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | ('newborn'/exp OR 'child, newborn':ti,ab OR 'full term infant':ti,ab OR 'human neonate':ti,ab OR 'human newborn':ti,ab OR 'infant, newborn':ti,ab OR 'neonate':ti,ab OR 'neonatus':ti,ab OR 'newborn':ti,ab OR 'newborn baby':ti,ab OR 'newborn child':ti,ab OR 'newborn infant':ti,ab OR 'newly born baby':ti,ab OR 'newly born child':ti,ab OR 'newly born infant':ti,ab OR 'prematurity'/exp OR 'infant, extremely premature':ti,ab OR 'infant, premature':ti,ab OR 'infant, premature, diseases':ti,ab OR 'neonate, premature':ti,ab OR 'pre-mature infant':ti,ab OR 'pre-term baby':ti,ab OR 'pre-term child':ti,ab OR 'pre-term infant':ti,ab OR 'pre-term neonate':ti,ab OR 'pre-term newborn':ti,ab OR 'premature':ti,ab OR 'premature baby':ti,ab OR 'premature birth':ti,ab OR 'premature child':ti,ab OR 'premature childbirth':ti,ab OR 'premature infant':ti,ab OR 'premature neonate':ti,ab OR 'premature newborn':ti,ab OR 'premature syndrome':ti,ab OR 'prematuritas':ti,ab OR 'prematurity':ti,ab OR 'preterm baby':ti,ab OR 'preterm child':ti,ab OR 'preterm infant':ti,ab OR 'preterm neonate':ti,ab OR 'preterm newborn':ti,ab OR 'nicu':ti,ab) AND [embase]/lim | 543 895 |
| Intervention: | ||
| 2. | ('web-cam':ti,ab OR 'webcam':ti,ab) AND [embase]/lim | 315 |
| Final | 1 AND 2 | 6 |
| /de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | 'nicu':ti,ab AND [embase]/lim | 13 391 |
| Intervention: | ||
| 2. | ('telemedicine'/exp OR 'tele medicine':ti,ab OR 'telemedicine':ti,ab OR 'teleconsultation'/exp OR 'remote consultation':ti,ab OR 'tele-consultation':ti,ab OR 'teleconsultation':ti,ab OR 'telephone consultation':ti,ab OR 'tele homecare':ti,ab OR 'tele care':ti,ab OR 'webcam':ti,ab OR 'web-cam':ti,ab) AND [embase]/lim | 23 549 |
| Final | 1 AND 2 | 51 |
| The search result, usually found at the end of the documentation, forms the list of abstracts; AB = Abstract; AU = Author; DE = Term from the thesaurus; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | (MH "Infant, Newborn") OR (MH "Infant, Low Birth Weight+") OR (MH "Infant, Premature") OR (MH "Neonatal Assessment+") OR (MH "Intensive Care, Neonatal+") OR (MH "Neonatal Intensive Care Nursing") | 125 126 |
| 2. | TI preterm OR TI newborn OR TI neonat* OR TI prematur* | 57 285 |
| 3. | AB preterm OR AB newborn OR AB neonat* OR AB prematur* | 78 779 |
| 4. | 1 OR 2 OR 3 | 174 733 |
| Intervention: | ||
| 5. | (MH "Telehealth+") OR (MH "Telephone Consultation (Iowa NIC)") | 19 713 |
| 6. | TI remote OR TI NTH OR TI telemedicine OR TI tele-care OR TI tele-homecare OR TI "tele care" OR TI "tele home care" OR TI telephone OR TI video OR TI smartphone | 21 802 |
| 7. | AB remote OR AB NTH OR AB telemedicine OR AB tele-care OR AB tele-homecare OR AB "tele care" OR AB "tele home care" OR AB telephone OR AB video OR AB smartphone | 59 468 |
| 8. | 5 OR 6 OR 7 | 83 599 |
| Final | 4 AND 8 AND published 20090101-20191231 | 1 595 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; AB = Abstract; AU = Author; DE = Term from the thesaurus; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | (MH "Infant, Newborn") OR (MH "Infant, Low Birth Weight+") OR (MH "Infant, Premature") OR (MH "Neonatal Assessment+") OR (MH "Intensive Care, Neonatal+") OR (MH "Neonatal Intensive Care Nursing") | 125 671 |
| 2. | TI preterm OR TI newborn OR TI neonat* OR TI prematur* OR TI NICU | 59 045 |
| 3. | AB preterm OR AB newborn OR AB neonat* OR AB prematur* OR AB NICU | 79 795 |
| 4. | 1 OR 2 OR 3 | 176 126 |
| Intervention: | ||
| 5. | TI webcam OR TI web-cam | 36 |
| 6. | AB webcam OR AB web-cam | 92 |
| 7. | 5 OR 6 OR 7 | 111 |
| Final | 4 AND 7 | 8 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; AB = Abstract; AU = Author; DE = Term from the thesaurus; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | TI NICU | 1 769 |
| 2. | AB NICU | 4 921 |
| 3. | 1 OR 2 | 6 038 |
| Intervention: | ||
| 4. | (MH "Telehealth+") OR (MH "Telephone Consultation (Iowa NIC)") | 19 918 |
| 5. | TI remote OR TI NTH OR TI telemedicine OR TI tele-care OR TI tele-homecare OR TI "tele care" OR TI "tele home care" OR TI telephone OR TI video OR TI smartphone OR TI webcam OR TI web-cam | 21 925 |
| 6. | AB remote OR AB NTH OR AB telemedicine OR AB tele-care OR AB tele-homecare OR AB "tele care" OR AB "tele home care" OR AB telephone OR AB video OR AB smartphone OR AB webcam OR AB web-cam | 59 795 |
| 7. | 5 OR 6 OR 7 | 84 107 |
| Final | 3 AND 7 | 160 |
Projektgrupp
Detta svar är sammanställt av Jessica Dagerhamn (projektledare), Sara Fundell (projektadministratör) samt Miriam Entesarian Matsson (produktsamordnare) vid SBU.
Granskningsmall för att översiktligt bedöma risken för snedvridning/systematiska fel hos systematiska översikter
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