Original Title: Teleneurología vs. consulta presencial. Revisión sistemática de su efectividad y coste-efectividad

Authors' objectives: To evaluate the evidence available of effectiveness and cost-effectiveness of remote consultation in neurology by videoconference (teleneurology) in comparison with standard consultation (face-to-face).

Authors' results and conclusions: RESULTS: The search strategies were applied in june and july 2006. 759 references were found, 12 of which were included in the study. The manual search showed 2 additional articles which were added. The distribution of the 14 included articles, by health problems, were: 5 articles about Stroke, 5 about Dementia, 1 about Dysarthria, and 3 articles with a mix of neurologic diseases. The most commonly used outcome measure was diagnostic reliability between teleneurology and face to face consultation. Overall, potential biases were poorly managed in the studies. We did not find any comparative study with sufficient length of follow up. Relevant health outcomes as could be potential differences in disease management, health-related quality of life, resource utilization, organizational impact or economic evaluations were not present in the included articles. CONCLUSIONS: Teleneurology is an emergent and promising technology although insufficiently assessed. The evidence available offer good levels of diagnostic reliability for patients with neurological damage after stroke. Evidence of reliability for evaluation of cognitive impairment and dementia in aging population is promising. More research is needed including comparative designs, better control of potential bias, and longer followup. Relevant outcome measures should be incorporated, such as health outcomes (clinical and self perceived), cost-effectiveness, and organizational impact of teleneurology to better inform health policy and clinical decision making.

Authors' methods: Systematic review of published literature in last 10 years (1996-2006). The search strategy was applied into databases as: MEDLINE, EMBASE, CINAHL, TIE, IME, COCHRANE LIBRARY, NHS-CRD, combining MESHterms and free text. Manual search was performed within the references of included studies and the website of HTA agencies. Articles selected were original studies (experimental or observational), comparing teleneurology and face-to-face consultation. Information was extracted and analyzed by two independent researchers. The quality of the studies included in this report was evaluated using an instrument specifically developed for this project based on the design and objective of the papers: transversal studies about diagnostic reliability and open trial. Due to the heterogeneity of the studies included meta-analysis was not possible. Instead, narrative synthesis including description of original studies is presented.

Project Status: Completed

Year Published: 2007

URL for published report: https://sescs.es/teleneurologia-vs-consulta-presencial/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es