Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jan 4, 2019
Open Peer Review Period: Jan 7, 2019 - Mar 4, 2019
Date Accepted: Jun 17, 2019
(closed for review but you can still tweet)
The use of telemedicine for the diagnosis of surgical site infections in LMICs: a systematic review
ABSTRACT
Background:
A high burden of preventable morbidity and mortality due to surgical site infections (SSIs) occurs in low- and middle-income countries (LMICs). The majority of these SSIs occur following discharge. There is a high loss to follow up due to a wide geographical spread of patients, and cost of travel resulting in delayed and missed diagnoses. This review analyses the literature surrounding the use of telemedicine, and assesses the feasibility of using mobile phone technology to diagnose SSIs remotely in LMICs and overcome social barriers.
Objective:
n/a
Methods:
A literature search was performed using Medline, Embase, CINAHL, PubMed, Web of Science, the Cochrane Central Register of Controlled Trials and Google Scholar. English language papers reporting the use of telemedicine for detecting SSIs in comparison to current practice of direct clinical diagnosis were included. Papers were excluded if infections were not due to surgical wounds, or if SSIs were not validated with in person diagnosis. The primary outcome of this review was to review the feasibility of telemedicine for remote SSI detection.
Results:
Four hundred and four articles were screened and three studies were identified reporting on 2082 patients across three countries. Two studies assessed the accuracy of remote diagnosis of SSIs using telephone questionnaires and the third by mobile phone image capture. In total 44 SSIs were accurately detected using telemedicine, and an additional 14 were picked up on clinical follow-up. The estimated cost of each telephone consultation was $0.50 USD.
Conclusions:
The use of telemedicine has shown to be a feasible method in remote diagnosis of SSIs. Telemedicine is a useful adjunct for clinical practice in LMICs to decrease loss to post surgical follow-up.
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.