JMIR Publications

ABSTRACT

Background:

Telemedicine includes the provision of any type of medical, diagnostic, or treatment-related service using telecommunications technology. Researches regarding telemedicine are increasing, however; it remains unclear how we should assess the usefulness and the limitation of telemedicine in the randomized controlled trials. It was also undefined which metrics to be used as cross-disciplinary indicators when comparing telemedicine with face-to-face care.

Objective:

This review aims to provide an overview of the general and crossdisciplinarity metrics used in comparing telemedicine with in-person care in randomized controlled trials. This study also aims to identify indicators that have not been evaluated and to suggest which ones should be used in future clinical trials.

Methods:

In the databases of MEDLINE and Embase, publications that met the inclusion criteria were searched according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines for a systematic scoping review. English original articles that dealt with randomized controlled trials comparing some form of telemedicine with face-to-face care were included, covering the period from January 2019 to March 2024. Basic study information and general metrics used in these studies were summarized.

Results:

Among 2,275 articles identified by the initial search, 79 were included in the final analysis. The commonly-used metrics that could be used across medical specialties were divided into the following three categories: (1) patient-centeredness (N = 67 [84.8%]) including patient satisfaction, patients’ work, and quality of life, (2) patient outcomes (N = 57 [72.2%]), i.e., general clinical parameters including death, admission, and adverse events, and (3) cost-effectiveness (N = 40 [50.6%]) including cost assessment and quality-adjusted life year. There were 25 studies (31.6%) that evaluated all of the three categories. Only a few studies (N = 7 [8.9%]) evaluated the metrics regarding staff convenience.

Conclusions:

There was a great variation among studies in which metrics were used. Even when disease-specific indicators are used, it was suggested that general indicators be used as well, to make it easier for people in other areas to understand the results. It was additionally suggested that indicators be set up to cover all the commonly-used three categories of measures: patient outcomes, patient-centeredness, and cost-effectiveness. In considering the further spread of telemedicine, it may be necessary to evaluate the convenience of staff. Standardization of evaluation metrics is desired for future clinical trials and studies.