Evaluating the use of telemedicine in gynaecological practice: a systematic review

Abstract

ObjectivesThe aim of this systematic review is to examine the use of telemedicine in the delivery and teaching of gynaecological clinical practice. To our knowledge, no other systematic review has assessed this broad topic.DesignSystematic review of all studies investigating the use of telemedicine in the provision of gynaecological care and education. The search for eligible studies followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and focused on three online databases: PubMed, Science Direct and SciFinder.Eligibility criteriaOnly studies within gynaecology were considered for this review. Studies covering only obstetrics and with minimal information on gynaecology, or clinical medicine in general were excluded. All English language, peer-reviewed human studies were included. Relevant studies published up to the date of final submission of this review were considered with no restrictions to the publication year.Data extractions and synthesisData extracted included author details, year of publication and country of the study, study aim, sample size, methodology, sample characteristics, outcome measures and a summary of findings. Data extraction and qualitative assessment were performed by the first author and crossed checked by the second author. Quality assessment for each study was assessed using the Newcastle-Ottawa scale.ResultsA literature search carried out in August 2020 yielded 313 records published between 1992 and 2018. Following a rigorous selection process, only 39 studies were included for this review published between 2000 and 2018. Of these, 19 assessed gynaecological clinical practice, eight assessed gynaecological education, one both, and 11 investigated the feasibility of telemedicine within gynaecological practice. 19 studies were classified as good, 12 fair and eight poor using the Newcastle-Ottawa scale. Telecolposcopy and abortion care were two areas where telemedicine was found to be effective in potentially speeding up diagnosis as well as providing patients with a wide range of management options. Studies focusing on education demonstrated that telementoring could improve teaching in a range of scenarios such as live surgery and international teleconferencing.ConclusionsThe results of this review are promising and demonstrate that telemedicine has a role to play in improving clinical effectiveness and education within gynaecology. Its applications have been shown to be safe and effective in providing remote care and training. In the future, randomised controlled studies involving larger numbers of patients and operators with measurable outcomes are required in order to be able to draw reliable conclusions.

Disruption in essential health services in Mexico during COVID-19: an interrupted time series analysis of health information system data

“…Telehealth strategies have been found to be effective in providing patient counselling and education, screenings, follow-up and refilling prescriptions, and have led to significant improvements in health outcomes. [56][57][58] However, the majority of studies on the effectiveness of telehealth were performed in high-income settings. There is an urgent need to assess the acceptability and effectiveness of telehealth for care in LMIC contexts.…”

The Use of Artificial Intelligence in Automation in the Fields of Gynaecology and Obstetrics – an Assessment of the State of Play

“…It is beyond dispute that, to date, only relatively few AI-based ultrasound applications have progressed fully from academic concept to clinical application and commercialisation. In addition to the importance of AI in prenatal diagnostics, as discussed in the following paragraphs, the advantages of AI-based automated algorithms have been very impressively demonstrated in reporting gynaecological abnormalities, a task that is bound to gain in importance, in particular, given the limited quality of existing ultrasound training 25 , 26 , 27 . Even though the first work in this field dates back more than 20 years 28 , significant pioneering work has been conducted in the last decade in particular, not least due to the extensive studies of the IOTA Working Group.…”

“…Unstrittig ist, dass bislang nur relativ wenige KI-basierte Ultraschallanwendungen den gesamten Weg vom akademischen Konzept zur klinischen Anwendung und Kommerzialisierung genommen haben. Neben der in den nachfolgenden Absätzen abgehandelten Bedeutung der KI in der pränatalen Diagnostik, zeigen sich die Vorteile von KI-gestützten automatisierten Algorithmen sehr eindrucksvoll in der Befundung gynäkologischer Auffälligkeiten, was insbesondere in Anbetracht der eingeschränkten Qualität der derzeitigen Ultraschallausbildung eine zusätzliche Wertschätzung erlangen wird 25 , 26 , 27 . Wenngleich die ersten Arbeiten hierzu schon mehr als 20 Jahre zurückliegen 28 , konnte insbesondere in der letzten Dekade maßgebliche Pionierarbeit, nicht zuletzt durch die umfangreichen Studien der IOTA Working Group, geleistet werden.…”

Surgeon satisfaction and outcomes of tele-proctoring for robotic gynecologic surgery

“…Studies looking at tele-proctoring in other fields have found this to be feasible, although widespread acceptance is lacking [3,[8][9][10]. A 2020 literature review found no studies focused on the use of robotic surgery for tele-mentoring or tele-proctoring in gynecology, thus this represents a critical literature gap [11].…”