Telemedicine in respiratory sleep medicine: COVID-19 pandemic unmasks the need for a process-oriented, replicable approach for implementation in clinical routine

Schöbel, Christoph; Werther, S.; Teschler, Helmut; Taube, Christian

doi:10.21037/jtd-cus-2020-011

Cited by 9 publications

(5 citation statements)

References 5 publications

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“…In analyzing the parameters of distance learning effectiveness, the main focus was tracking the qualitative indicators of student performance compared to the results achieved in traditional face-to-face classes. The authors of this study were aware of the fact that the data obtained had to be more focused on the analysis of prerequisites, needs, and processes than on the evaluation of outcomes (Hannila et al, 2019;Rentes et al, 2019;Beier et al, 2020;Schöbel et al, 2020). Accordingly, in this case, the efficiency level was defined as the ratio of outcomes to resources expended, considering the urgency of the tasks.…”

Section: Discussionmentioning

confidence: 99%

Advantages and disadvantages of distance teaching in foreign language education during COVID-19

2022

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This article aimed to analyze the identified advantages and disadvantages of distance education in foreign language teaching in the transition to distance learning due to the COVID-19 pandemic. The data were collected through questionnaires and observations. A total of 298 university students participated in the research. The results of this research show that (1) the quality parameters of the changes and additions to the curriculum of foreign language teaching, (2) the final evaluation of the students in these subjects conducted in distance learning compared to the results shown in the offline form, (3) the satisfaction of the students with the electronic format of academic subjects, and (4) the formation of communicative competences under the changed learning conditions. The results are based not only on the final grades in the control sections in written and oral form but also on the emotional evaluation of the distance format teaching units in foreign languages. In addition, the results have shown that a complete transition to distance education is possible at COVID as a contingency measure. The research results will help to solve problematic issues related to the organization of the educational process and the need to comply with sanitary regulations.

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Section: Discussionmentioning

confidence: 99%

Advantages and disadvantages of distance teaching in foreign language education during COVID-19

2022

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“…From mid-March 2020, there has been an observed 80% decrease in office visits and 56-fold increase in virtual care visits. 18 The benefits of telemedicine including telediagnosis, teletherapy, telemonitoring and teleconsultation have reduced waiting times, transportation time, visit costs and lowered infections rates, [43][44][45][46][47][48] which may also better accomodate schedules of families while reducing the need to take time off work or arranging for childcare. However, the disadvantages of telemedicine includes the inability to perform most physical examinations or procedures, difficulty establishing new therapeutic relationships which are especially important for sustaining PAP use and reinforcing education around sleep hygiene issues particularly during adolescence, dealing with certain complex mental health issues, difficulty with interpreting body language and nonverbal clues, and lacking the full degree of comfort and support that can be provided in person as well as privacy and continuity of care concerns.…”

Section: Discussionmentioning

confidence: 99%

To Wear or Not Wear the Mask: Decline in Positive Airway Pressure Usage in Children with Sleep Disordered Breathing During the COVID-19 Pandemic

Sunkonkit¹,

Selvadurai²,

Voutsas³

et al. 2022

NSS

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Positive airway pressure (PAP) therapy is an effective treatment prescribed to children with sleep disordered breathing (SDB); however, PAP adherence remains challenging. Given that COVID-19 pandemic continues to impact sleep and daily life, the aim of this study was to evaluate longitudinal trajectory of PAP usage in children during the COVID-19 pandemic. Patients and Methods: This was a retrospective study. Children aged 1-18 years with SDB prescribed PAP at The Hospital for Sick Children (Toronto, Canada) were evaluated for PAP adherence. Demographics, medical history and PAP adherence data during four consecutive 3-month time periods from December 2019 to December 2020 were collected. These four time periods included i) prior to COVID-19 lockdown, ii) during the first three months of lockdown, iii) summer and iv) return to school period. Percentage of days where PAP was used for ≥4 hours and average nightly usage of PAP were primary outcomes. Results: A total of 149 children (61.7% male, mean (±SD) age=12.8 ± 4.1 years, BMI (±SD) z-score=1.45±1.43) were enrolled. Compared to prior to lockdown, the median (IQR) of percentage of PAP usage ≥4 hours and average nightly usage of PAP declined significantly during the summer and return to school periods (p<0.001 for all). By the end of the return to school period, only 69/149 (46%) showed sustained PAP usage and 80/149 (54%) had decreased PAP usage. Obesity was a risk factor for a decline in PAP usage after returning to school (β=−15.36, p=0.03). Conclusion: Compared to COVID-19 pre-pandemic PAP usage, there was a significant decline in PAP usage across COVID-19 pandemic. There is critical under usage of PAP in children diagnosed with SDB, resulting in an urgent need to address barriers to mitigate poor adherence to PAP long-term. Targeted strategies are required to optimize PAP adherence in children with SDB.

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“…Furthermore, the described comparison is of fundamental importance, not only from an economic point of view, but especially in light of the ongoing pandemic. The COVID-19 pandemic fuels the need for implementation of telemedicine in clinical practice mainly to prevent unnecessary traveling and face-to-face consultations of patients with a consequent reduction in exposure time, a decrease in infection risk, and in the provision of clinical capacities for COVID-19 patients [34][35][36]. In particular, the decrease in infection risk is achieved both by limiting the number of time patients access the hospital and by the use of disposable devices, with a much higher degree of safety with respect to devices in need of disinfection.…”

Section: Discussionmentioning

confidence: 99%

Multiple-access versus telemedicine home-based sleep apnea testing for obstructive sleep apnea (OSA) diagnosis: a cost-minimization study

et al. 2021

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PurposeThe aim of the present study was to compare two clinical pathways: the multiple-access outpatient pathway versus the telemedicine pathway. Methods The multiple-access outpatient pathway and the telemedicine pathway were both performed with WatchPAT and implemented in a real-life healthcare scenario, adopting a cost-minimization approach. A cost-minimization analysis was undertaken to assess the economic impact of the two alternatives. The cost analyses were performed in euros for the year 2021 adopting the patient, the hospital, and the societal perspectives. Given the chosen perspectives, direct medical costs, direct nonmedical costs, and indirect costs were considered. In addition, a univariate sensitivity analysis was conducted. Results From a hospital perspective, the telemedicine approach was estimated to cost €49 more than the multiple-access alternative. Considering the patient perspective, the telemedicine approach was estimated to cost €167 less than the multipleaccess pathway. Considering the societal perspective, the telemedicine approach is estimated to cost €119 less than the multiple-access pathway. ConclusionThe adoption of telemedicine home sleep apnea testing could improve the efficiency of the healthcare processes if considering the direct and indirect costs incurred by patients and not only by healthcare providers.

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Telemedicine in respiratory sleep medicine: COVID-19 pandemic unmasks the need for a process-oriented, replicable approach for implementation in clinical routine

Abstract: reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide.

Cited by 9 publications

References 5 publications

Advantages and disadvantages of distance teaching in foreign language education during COVID-19

Advantages and disadvantages of distance teaching in foreign language education during COVID-19

To Wear or Not Wear the Mask: Decline in Positive Airway Pressure Usage in Children with Sleep Disordered Breathing During the COVID-19 Pandemic

Multiple-access versus telemedicine home-based sleep apnea testing for obstructive sleep apnea (OSA) diagnosis: a cost-minimization study

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