中国远程医疗研究现状分析

Status Quo of Telemedicine in China

目的定性分析以中文发表的中国远程医疗研究文献。方法计算机检索CBM、VIP、CNKI和中国社会科学引文数据库(CSSCI)等,全面收集与远程医疗有关的临床研究,检索时限均为建库至2012年3月,并追溯纳入研究的参考文献。由两位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,对纳入研究的应用领域、范围、效果等方面进行定性分析。结果最终纳入19篇文献,包括16个半随机对照试验和3个观察性研究。按照JBI质量评价标准,16个半随机对照试验中有12个为中等质量,4个为低质量;3个观察性研究均为低质量。定性分析结果显示:远程医疗的文献报道从1995年起逐年增加,但研究类文献在2002年才开始发表,文献数量保持均匀态势发展,发表杂志比较分散。按照远程医疗技术的应用范围分类,15个(80%)应用在远程监护方面,尤其是远程胎儿监护,4个(21%)用于远程会诊,3个(16%)用于远程治疗,19个研究结果均提示远程医疗效果优于传统医疗。结论我国远程医疗研究文献数量逐年增多但研究质量不高,需要进一步开展高质量研究;远程医疗技术的应用范围分布不均衡,多集中在远程监护方面;远程医疗的治疗效果良好,监测数据准确,为患者带来便利。

Objective To review published literature on telemedicine in China using qualitative analysis. Methods Such databases as CBM, VIP, CNKI, and CSSCI were electronically and comprehensively searched for clinical studies related to telemedicine from inception to March 2013. References of the included studies were also retrieved. Two reviewers independently identified the literature according to inclusion and exclusion criteria, extracted data, and assessed the quality of the included studies. Then, qualitative analysis was performed in aspects of the application fields, range, and effects of the included studies. Result Finally, 19 studies were eligible for the analysis, including 16 quasi-randomized controlled trials and 3 observational studies. According to methodological evaluation standards （JBI, 2005）, among 16 quasi-randomized controlled trials, 12 were of medium quality and four were of low quality; and 3 observational studies were all of low quality. The results of qualitative analysis showed that, literature on telemedicine had increased by year since 1995. However, the literature on relevant research of telemedicine had been published since 2002. The number of literature increased evenly and sporadically in journals. According to the classification of the application fields of telemedicine, 15 （80%） related to remote monitoring, especially related to remote fetal monitoring, 4 （21%） were remote consultation, and 3 （16%） were remote treatment. The results of 19 studies showed that, telemedicine had better effects than traditional medicine. Conclusion In China, literature related to telemedicine increases by year but the quality of them are low. High quality studies are further needed. The distribution of the application fields of telemedicine is uneven, most of which focuses on remote monitoring. The quality of research is low and need high-quality research in future. The therapeutic effects of telemedicine are better with accurate monitoring data and convenience to patients..