Telemedicine infectious diseases consultations and clinical outcomes: a systematic review and meta-analysis protocol

Abstract

Background Telemedicine use is increasing in many specialties, but its impact on clinical outcomes in infectious diseases has not been systematically studied and reviewed. The proposed systematic review will evaluate the current evidence regarding the effect of telemedicine infectious diseases consultation on a range of clinical outcomes, including mortality, hospital readmission, antimicrobial use, and cost. Method/design Standard systematic review methodology will be used, with searches of Ovid MEDLINE 1946-, https://embase.com/ 1947-, Scopus 1823-, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), and https://clinicaltrials.gov/ 1997-. There will be no restriction on language or year of publication. The primary outcome will be 30-day all-cause mortality and secondary outcomes will include readmission within 30 days after discharge from an initial hospitalization with an infection, patient compliance/adherence, patient satisfaction, cost or cost effectiveness, length of hospital stay, antimicrobial use, and antimicrobial stewardship. Bias will be assessed using standard Cochrane methodologies. Data will be grouped by outcome and narratively synthesized. Meta-analysis will be performed for outcomes with clinical or methodological homogeneity. The systematic review and meta-analysis will be registered through PROSPERO. Pre-planned subgroup analyses will be detailed. Discussion A number of studies have documented the feasibility of telemedicine for infectious diseases, but a synthesis of clinical outcomes data with telemedicine infectious diseases consultation has not been performed. This systematic review will analyze many clinical outcomes of telemedicine infectious diseases consultation. The findings of this study will add to established literature about feasibility of telemedicine consultation by synthesizing the evidence for clinical effectiveness. Systematic review registration PROSPERO CRD42018105225 Electronic supplementary material The online version of this article (10.1186/s13643-019-1056-y) contains supplementary material, which is available to authorized users.

Health system performance and health system preparedness for the post-pandemic impact of COVID-19: A review

“…Inadequate existing bed capacity is an obvious reason for long waiting lists for elective procedures in NHS hospitals. The effects of switching to telemedicine for patient consultations has been discussed [28] and this may be a choice for patients with an infectious disease with early symptoms who could be managed at home. Using appropriate but narrow admission and discharge policies to streamline patient flow for patients who are more ill has been effective in some epidemics in resource constrained situations [29].…”

Core Recommendations for Antifungal Stewardship: A Statement of the Mycoses Study Group Education and Research Consortium

“…While face-to-face consultation is commonplace in the US and may be preferable, it is not always readily available in all circumstances and resource-limited settings. In these situations, it may be especially important to implement other pathways and stewardship interventions to optimize care [42,43,122,123]. A recent study evaluated published data on outcomes of telemedicine vs in-person ID consultation, but the variety of methods and outcomes used in the primary literature hampered metaanalysis [123].…”

Successful Use of Telemedicine Infectious Diseases Consultation With an Antimicrobial Stewardship-Led Staphylococcus aureus Bacteremia Care Bundle

“…The results of our cohort add to available literature by further supporting TM use to provide specialty care to underserved patient populations. Although a bulk of current data reports patient satisfaction around TM, we were able to demonstrate similar clinical outcomes for a complex clinical scenario independent of the mode of ID consultation [ 16 , 24 , 25 ]. In addition to clinical outcomes, we identified that adherence to the SAB bundle was not different by mode of care delivery.…”