International journal of medical informatics · 2025
The clinical effectiveness in telemedicine in Trauma: A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Nouh Thamer, Shalhoub Mishary, Alburakan Ahmed, Alshahwan Nawaf, Kaaki Suha, Hemdi Mohannad, Zelfawi Lama Al, Almajed Ebtesam, Aldayel Ghadah, Alharthi Alanood, AlSarhan Reem, Altamimi Reem, Alotaibi Kayan, Aldeligan Saleh, Alsughayyir Abdulrahman, Alharbi Ghada, Mashbari Hassan
Аннотация
BACKGROUND: Telemedicine (TM) has emerged as a transformative tool in trauma care, enabling remote consultation and guidance for healthcare providers, especially in resource-limited settings. This review evaluates TM's effectiveness in trauma care by assessing its impact on clinical outcomes, mortality, injury severity, and healthcare resource utilization.
PATIENTS AND METHODS: A systematic literature search was performed across PubMed, Google Scholar, Science Direct, ProQuest, Medline, and Web of Science and included randomized controlled trials and cohort studies involving adult trauma patients. Extracted data encompassed demographics, injury characteristics, and clinical outcomes.
RESULTS: Analysis of 25 studies (n = 45,097 patients) revealed that TM was associated with higher Injury Severity Scores (ISS), likely due to improved detection and documentation of severe injuries through specialist input. Increased blood transfusion rates were observed, which may reflect more accurate triage and timely intervention facilitated by TM, though confounding factors (e.g., case mix) cannot be ruled out. Both patient and physician satisfaction rates were high. However, TM demonstrated no statistically significant effect on mortality (p > 0.05), transfer times, or emergency department (ED) utilization-a finding consistent with some prior studies but warranting further investigation, given the heterogeneity in protocols.
CONCLUSION: TM enhances trauma care coordination in rural and underserved areas by improving access to specialist expertise, which may explain observed benefits like higher ISS detection and transfusion rates. However, its inconsistent impact on mortality and resource use underscores the need for standardized implementation protocols. Future integration should optimize TM workflows (e.g., reducing decision delays) and pair them with targeted resource allocation to maximize outcomes.
PATIENTS AND METHODS: A systematic literature search was performed across PubMed, Google Scholar, Science Direct, ProQuest, Medline, and Web of Science and included randomized controlled trials and cohort studies involving adult trauma patients. Extracted data encompassed demographics, injury characteristics, and clinical outcomes.
RESULTS: Analysis of 25 studies (n = 45,097 patients) revealed that TM was associated with higher Injury Severity Scores (ISS), likely due to improved detection and documentation of severe injuries through specialist input. Increased blood transfusion rates were observed, which may reflect more accurate triage and timely intervention facilitated by TM, though confounding factors (e.g., case mix) cannot be ruled out. Both patient and physician satisfaction rates were high. However, TM demonstrated no statistically significant effect on mortality (p > 0.05), transfer times, or emergency department (ED) utilization-a finding consistent with some prior studies but warranting further investigation, given the heterogeneity in protocols.
CONCLUSION: TM enhances trauma care coordination in rural and underserved areas by improving access to specialist expertise, which may explain observed benefits like higher ISS detection and transfusion rates. However, its inconsistent impact on mortality and resource use underscores the need for standardized implementation protocols. Future integration should optimize TM workflows (e.g., reducing decision delays) and pair them with targeted resource allocation to maximize outcomes.