Clinical Trials on Computer Based Telemedicine: A Systematic Review

IntroductionRecent developments in the field of ICT may have an impact on telemedicine. This systematic review aims to evaluate the recent clinical trials of telemedicine in relation to store-and-forward, real time and remote monitoring methods.MethodArticles were obtained from November 2007 to November 2009 using the MEDLINE database. Studies reported on clinical trials were included and those indicating the use of telephony, electrical equipment and feasibility studies were excluded. Articles were abstracted and grouped for various disciplines for analysis.ResultsThere were three large sample Randomised Control Trials (RCTs), nine small sample RCTs, four prospective studies, three retrospective studies, one cohort study, four case control studies, and fifteen descriptive studies. The three large sample RCTs have been reported one each in neurology, diabetes and dermatology.Thirty nine articles selected were nine on neurology, four each on psychiatry, diabetes and cardiology, three each on ophthalmology and dermatology, two each on acute care, transplant and ENT and one each on child abuse, endoscopy, general practice, leprosy, nephrology and radiology.After further exclusion, rest of the 27 articles revealed that the outcome had improved in 41%, comparable in 15%, benefited in 33% and not enhanced in 11% when telemedicine was compared to conventional approaches.ConclusionsMost of studies reported have revealed advantages of telemedicine against conventional methods of care. However further large sample randomized controlled trials are necessary to confirm these results.