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.

Lästid: ca 12 min Publicerad: Publikationstyp:

SBU:s upplysningstjänst

Strukturerad litteratur­sökning som besvarar fråga från vården eller social­tjänsten om vilka relevanta översikter och studier som finns. Vi bedömer risken för bias i systematiska översikter och vid behov även kvalitet och över­förbarhet av resultaten i hälso­ekonomiska studier. Svaret utformas av medarbetare på SBU, vid behov med stöd av ämnessakkunnig.

Kontakta SBU
Publicerad: Rapportnr: ut201936 Diarienr: SBU 2019/680 https://www.sbu.se/ut201936

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Sökord

Telekonsultation

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

PubMed via NLM 2019-09-05 
Neonatal telemedicine
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

 

PubMed via NLM 2019-10-17 
Neonatal telemedicine
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

 

PubMed via NLM 2019-10-17 
Neonatal telemedicine
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

 

Cochrane Library via Wiley 2019-09-05 
Neonatal telemedicine
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

 

Embase via embase.com 2019-09-05 
Neonatal telemedicine
/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

 

Embase via embase.com 2019-10-17 
Neonatal telemedicine
/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

 

Embase via embase.com 2019-10-17 
Neonatal telemedicine
/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

 

Cinahl via ebsco.com 2019-09-26 
Neonatal telemedicine
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

 

Cinahl via ebsco.com 2019-10-17 
Neonatal telemedicine
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

 

Cinahl via ebsco.com 2019-10-17 
Neonatal telemedicine
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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