Telemedicine For Diagnosis Research Articles

Telemedicine for diagnosis or treatment during Covid-19: systematic review

Objective: To describe the use of telemedicine by health professionals for diagnosis or treatment of patients during the Covid-19 pandemic. Method: This is a systematic literature review of observational studies. Five databases were used. The assessment of the studies methodological quality occurred individually among the revisors and the Joanna Briggs Institute tool was used. Results: The reviewers selected 22 articles from 6,180 works. The services provided through telemedicine were consultation/screening, consultation/follow-up or monitoring, test reports, medication prescriptions and case discussions. The technological resources used were platforms using video and telephone (audio and video). The use of telemedicine made it possible to reduce their exposure to Covid-19, reduce social panic and anxiety, quickly medical specialties access and the possibility of access to diagnosis and treatment of patients with chronic and acute diseases. Conclusion: Telemedicine can be an important tool in healthcare, keeping patients and healthcare professionals safe during the Covid-19 pandemic.

Telemedicine in Care of Sarcoma Patients beyond the COVID-19 Pandemic: Challenges and Opportunities.

The COVID-19 pandemic has created a challenging environment for sarcoma patients. Most oncology societies published guidelines or recommendations prioritizing sarcoma patients and established telehealth as an efficient method of approaching them. The aim of this review is the assessment of current evidence regarding the utilization of telemedicine in diagnosis, treatment modalities, telerehabilitation and satisfaction among sarcoma patients and healthcare providers (HP). This systematic review was carried out using the databases PubMed and Ovid MEDLINE according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The application of telemedicine to the management of sarcoma has yielded improved clinical and psychological outcomes. Specifically, significant progress has been demonstrated in the areas of tele-oncology and telerehabilitation during the last decade, and the COVID-19 outbreak has accelerated this transition toward them. Telehealth has been proven efficient in a wide spectrum of applications from consultations on physical therapy and psychological support to virtual care symptom management. Both HP and patients reported satisfaction with telehealth services at levels comparable to in-person visits. Telehealth has already unveiled many opportunities in tailoring individualized care, and its role in the management of sarcoma patients has been established in the post-COVID-19 era, as well.

Pros and cons of telemedicine in diagnosis and management: A cross sectional survey

Introduction: Cost effectiveness, equity, and quality all are problems facing the health care services in both developed and developing countries. Modern technologies as telemedicine tried to help population especially in epidemics. Many malpractice problems facing doctors and other health care workers due to using telemedicine. This study aimed to clarify the pros and cons of telemedicine. Method: Survey was done and validated to health care worker sectors, patients and judicial workers sectors, to evaluate the telemedicine according to their practice. Results: about one thousand volunteers shared in this study, 616 (61.3%), 68 (6.8%) judicial workers, and 320 (31.9%) other jobs. Most of doctors 95% of them refuse to use telemedicine in the provisional diagnosis, 77.3% claim that it is very difficult to give accurate diagnosis through media, 75.6% of them convinced that telemedicine and increase the malpractice issues and medical responsibilities. In judicial workers 64.7% of them prove that there is increase in malpractice issues due to use of media. On the other side 55% of the other job sectors agree with the use of telemedicine especially in time of epidemics. Conclusion: Telemedicine has many pros and cons. The main cons were that the inability to give the actual diagnosis and occurrence of medical errors, while the main pros was that the use of telemedicine to follow up already diagnosed patient. Governments should legalize the using of telemedicine by enacting law that prohibit the use of it except between doctors to take medical decision or exchange opinion.

Benefits of telemedicine in diagnosis of herpes zoster ophthalmicus with timely management and follow-up

Sir, Herpes Zoster is caused by the viral reactivation of Varicella Zoster virus, that enters the cutaneous nerve endings during an earlier episode of chicken pox and travels to the Dorsal Root Ganglia and remains latent. It is characterized by the occurrence of vesicular lesions grouped along the Single Dermatome innervated by Dorsal Root of Sensory Ganglion. Herpes Zoster Ophthalmicus (HZO) is involvement of the ophthalmic division of the fifth cranial nerve. It is the second most common type of Herpes Zoster (HZ), after Thoracic Zoster [1]. We present here, a case of Herpes Zoster in a young girl involving Supraorbital, Maxillary and Mandibular of the Trigeminal nerve. Timely diagnosis of HZO was made. The lesion on the tip of the nose (Hutchinson’s sign) alerted the involvement of Nasociliary nerve and to arrange immediate Ophthalmology consultation. Tele-Dermatology helped in reducing waiting time, fast delivery of care and prevention of visual disability [2]. The patient was monitored, motivated and treated, that could happen because of tele- dermatology. Dramatic improvement in the patient was observed in a very short time. The use of tele-dermatology, especially in times of the COVID – 19 pandemic is invaluable. The patient was a girl aged 12-years, presented through telemedicine with 3 days of lesions on the face mimicking acne. On close examination, there were a few Vesicular Lesions among multiple lesions and there was involvement of tip of the nose. Patient also complained of eye pain. This helped us to consider HZO. Prompt immediate treatment with anti-virus was initiated. It was possible to do continuous monitoring with the help of Tele-Medicine and without the patient having to leave the house in COVID era. Patient was advised to consult an Ophthalmologist for further evaluation. As it was essential, for examination of the eye parameters, patient had to attend in person. This one visit was not through Tele-Medicine. Patient was informed on day-1 of treatment that the condition may initially worsen under proper adequate treatment with a graphic representation (Fig. 1) and then decrease later. And this happened in our case, as seen in the six consecutive photographs as indicated below with date and time of the photographs by the patient, which are presented to illustrate the natural progression of disease under proper adequate treatment. This helped in avoiding panic to the patient. The lesions as seen in the pictures became aggressive in two days which means, the eye could have been affected more but for the immediate treatment given. Patient could get treatment from home by consulting online through out, thereby reducing the risk of venturing to a clinic in COVID situation. Except for one visit to the Ophthalmologist which was inevitable. Ocular Manifestations – Ocular manifestations affect about 50% of patients with HZO and can be isolated. This proportion reaches 80% in case of appearance of the Hutchinson Sign. The latter reflects the involvement of the nasociliary branch and is characterized by eruption on the side and on the tip of the nose [3]. Eye examination showed that there was congestion generalized in Conjunctiva. Corneal sensation was reduced, Iris anterior chamber, Pupil, lens, Fundus and extra ocular movements were normal. Immediate treatment was instituted after counselling about the treatment. The patient was advised Valacyclovir 1000 mg, 3 times a day for 7 days along with adequate fluid intake. For relief of pain, patient was given Pregabalin, Tremedol 25 mg and Gabapentin 6%W/W+Lidocaine 5%W/W smooth locally. Eye treatment As per Ophthalmologists advice, Polyethylene glycol 400 0.4% + Propylene glycol 0.3% five times a day and Acyclovir eye ointment a day was prescribed to the patient. All the pictures were taken by the patient and shared with the doctor, during the course of the treatment helping in regular monitoring have been presented (1a – 1f). In this case, Telemedicine gave the scope of reducing waiting time, providing correct diagnosis, enabling faster delivery of care, enabling tele based access to monitor the patient’s condition, counselling, management, monitoring with good end result. Key Takeaways • The importance of (Hutchinson’s sign) involvement of the tip of nose is emphasized. • Counselling the patient with regard to the possibility of worsening of the visible symptoms while under appropriate and adequate treatment, should be given with the help of a graphic representation (Fig. 2). • Prompt referral to Ophthalmologist is necessary. • The consultant and the patient should be conscious of associated potential Vision threatening complications and the need for prompt treatment to protect from visual complications.

COVID-19’s Impact on Genetics at One Medical Center in New York

COVID-19’s Impact on Genetics at One Medical Center in New York

Role of Social Media and Telemedicine in Diagnosis & Management of COVID-19; An Experience of the Iranian Society of Radiology.

Role of Social Media and Telemedicine in Diagnosis & Management of COVID-19; An Experience of the Iranian Society of Radiology.

National electrocardiographic mapping by telemedicine for diagnosis and prevention of cardiological pathologies in Paraguay

Introduction: Telemedicine tools offer multiple advantages to achieve an epidemiological screening of communities in rural settings countrywide. However, evidence on the cardiological pathology surveillance in these communities is limited. The feasibility of telemedicine as an electrocardiographic (EKG) mapping tool for the diagnosis and prevention of cardiological pathologies in Paraguay was investigated. Methods: A descriptive study was conducted in 60 telediagnostic centers countrywide in Paraguay to evaluate the feasibility of telemedicine as an EKG mapping tool for the diagnosis and prevention of cardiological pathologies over a period of 5 years from 2014 to 2018. The adherence rate was determined comparing yearly scheduled visits versus fulfilled visits at the telemedicine platform. Results: During the study, 246,217 remote EKG diagnoses were performed in 60 hospitals using telemedicine. The patients were 19.4% children/adolescents and 80.6% adults. The results of EKG tests in the children/adolescent group were 79.4% normal and 20.6% abnormal. The most frequent abnormal heart rhythms observed were sinusal bradicardia (10.6%), sinusal tachycardia (3.2%), and unspecified arrhythmia (2.8%). In the adult group, the results were 66.3% normal and 33.7% abnormal. The most frequent abnormal heart rhythms in this group were sinusal bradicardia (11.2%), blockade of the right branch (4.8%), and left ventricular hypertrophy (4.7%). The most frequent cardiovascular risk factors observed were the association of hypertension and obesity (40%), hypertension and diabetes (20%), and hypertension and dyslipidemia (19%). During the test period (2014–2018), the average rate of patient adherence to the prevention program was 2.26 for each 1000 diagnosis. Conclusion: These results demonstrate the feasibility of telemedicine as an EKG mapping tool for the diagnosis and prevention of cardiological pathologies in low-resource countries, thus enhancing cardiovascular disease surveillance and optimizing human and financial resources.

PP05 Developing Equity In Remote Locations Through Telediagnosis

Introduction:Clinical background: Until recently, populations living in remote areas did not have access to specialist care and quality diagnostic services and thus depended on the low response capacity of their local health system. Subsequently, there were equity issues between urban and rural populations. Therefore it was considered telediagnosis applications should be directed towards developing better equity in the provision of services in remote locations without access to specialists. This study has evaluated the results of a new telemedicine system in remote public hospitals in Paraguay, in order to show how the response capacity of the local integrated health service delivery networks has been improved by providing access to tertiary level diagnostic services by specialists. Objective: This study aims to evaluate the utility of telemedicine as a tool for developing better equity in the provision of services in remote locations.Methods:This was a descriptive study, where the results of using telemedicine for diagnosis in remote public hospitals were evaluated as a tool to improve access to diagnostic services countrywide between 2014–2017. For these purposes, type and frequency of pathology diagnosed was determined.Results:A total of 311,562 telediagnoses were performed in fifty-seven hospitals. The 191,435 electrocardiogram diagnosis performed in the fifty-five hospitals were mainly normal (62.1%), unspecified arrhythmias (12.5%), and sinus bradycardia (10.4%). Also 115,924 teletomography tests were performed in twelve hospitals, where 54.4 percent corresponded to head as a consequence of accidents (motorcycles) and cerebrovascular diseases, 13.8 percent to chest, and the rest the other anatomical regions. Regarding the 4,184 electroencephalogram tests performed, antecedents of seizure (54.3%), evolutionary controls (14.0%), and headache (11.5%), were mainly diagnosed. The nineteen ultrasound studies corresponded to prenatal controls.Conclusions:Despite the results of the telediagnosis implemented in the public health to develop better equity in the provision of services in remote locations, a widespread use-assessment should be analyzed before this tool is adopted.

VP21 Telemedicine As A Tool For Public Health Planning

INTRODUCTION:The telediagnostic systems can achieve relevant epidemiological information from local community needs to global countrywide opportunities. In this context the telemedicine applications should be directed to gain the prevalence of pathologies towards developing better equity in the provision of services (1), and greater concern for the effectiveness and usefulness of health technologies in remote locations without access to specialists (2). This study, has evaluated the results of a telemedicine system in remote public regional and district hospitals in Paraguay (3), in order to show the epidemiological trends in communities of a low income country.METHODS:This prospective study used the results of telemedicine for diagnosis in remote regional and district hospitals to evaluate a as tool to determine the prevalence of pathologies countrywide over three years (2014-16). For these purposes, type and frequency of pathology diagnosed was determined. Sampling was non-probabilistic of convenience.RESULTS:A total of 182,406 telediagnoses were performed in 54 hospitals. The electrocardiography (ECG) diagnosis performed in the 52 hospitals were normal (62.1 percent), unspecified arrhythmias (12.5 percent), sinus bradycardia (10.4 percent), left ventricular hypertrophy (4.1 percent), sinus tachycardia (4.4 percent), right bundle branch block (3.5 percent), ischemia (1.4 percent), atrial fibrillation (1.0 percent) and left bundle branch block (0.6 percent). Teletomography was performed in twelve hospitals, where 54.4 percent corresponded to skull as a consequence of accidents (motorcycles) and cerebrovascular diseases, 13.8 percent chest, 6.2 percent dorsal spine, 5.4 percent abdominal and the rest the other anatomical regions. Regarding electroencephalography (EEG), antecedents of seizure (54.3 percent), evolutionary control (14.0 percent), headache (11.5 percent), cognitive impairment (2.0 percent), attention deficit in children (learning) (2.0 percent), brain death (1.0 percent), abnormal movements (0.8 percent), and sleep disturbances (0.3 percent) were diagnosed. The nineteen ultrasound studies corresponded to prenatal controls.CONCLUSIONS:Despite the results of the telediagnosis implemented in the public health system to determine the prevalence of pathologies countrywide, a widespread use-assessment should be analyzed before deciding a large diffusion as a tool for public health planning.

The Cloud Stroke Unit: 24-Hour Acute Stroke Expertise-on-Demand

The use of telemedicine, especially as it is relates to telestroke, has significantly expanded over the past one or two decades. The fact that stroke therapy is a time-critical disease process, coupled with the relative paucity of stroke-trained practitioners, makes telestroke an attractive technique of care. The authors’ objective was to summarize the evidence that support the reliability of telemedicine for diagnosis and efficacy in acute stroke treatment in collaboration between hospitals in two different countries.

Perspectives of Teleconsultation in Craniomaxillofacial Surgery

The application of computer technology in craniomaxillofacial surgery has opened new perspectives in preoperative planning and accurate intraoperative realization of treatment concepts. To simulate the postoperative outcome, the treatment plan is based on 3-dimensional (3D) visualization of computed tomography (CT) or cone-beam CT data. To transfer the implant simulation to the patient, passive navigation with the help of surgical guides or active navigation with real feedback during surgery is used. 1-3 Both concepts show similar accuracy in vitro 4 because the simulation of dental implant position is based on CT or cone-beam CT data. In vivo accuracy can be compromised by patient head movement during scan acquisition 5 and limitations of CT accuracy. 6,7 The transmission of digital imaging data and the corresponding treatment plan via telecommunication have opened new horizons for telemedicine in diagnosis and care delivery. In the case of image-guided surgery, the preoperative 3D simulation combined with the realtime display of the virtual instrument 3D position relative to the patient’s anatomy that guides the surgeon during surgery can be transmitted via high-speed transmission networks. There are 2 ways to convey the knowledge and the physical skill of a surgeon over long distances: telesurgery or teleconsultation. Telesurgery is performed

Preliminary results from a telemedicine referral network for early diagnosis of sleep apnoea in sleep laboratories

We conducted a feasibility study to find out whether a simple preliminary examination using telemedicine for diagnosis was sufficient to identify sleep-related breathing disorders (SRBD). Night-time pulse oximetry recordings were made in normal home surroundings on patients suffering from sleep apnoea/SRBD by doctors with a range of non-specialist backgrounds. The readings were transmitted to the relevant sleep laboratory, examined and the results returned to the referring doctor. From 80 patients (aged 29 to 60 years), 58 complained about characteristic symptoms (snoring, daytime sleepiness); 33 of these patients showed additional symptoms of associated diseases. In eight patients associated diseases were found without any symptoms. The findings were compatible with SRBD in 58 cases (73%); 12 of these were asymptomatic patients. A total of 57 patients had to be referred to a sleep laboratory for differential diagnosis by full polysomnography. Of the 22 patients (28%) without pathological findings following pulse-oximetry, 12 were symptomatic. The system described here is suitable for the creation of referral networks and for the identification of patients from institutions not trained in sleep medicine, who would otherwise not have been referred for specific diagnosis to a sleep laboratory.

Telemedicine in otorhinolaryngology exemplified by a Tübingen-Leipzig video conference

"Telemedicine" is a major new development with great potential for improving health care delivery. It therefore affects each department in medicine. There is a great deal of telemedicine activity around the world. However, the term telemedicine is not clear. It describes all forms of medical information, transferred from a relevant distance by an electronic transfer media. An essential condition for communication is the intelligibility between transmitter and receiver. Because of different transmitting technologies and networks in distinct countries, towns, or even academic institutions, satisfactory contact is not possible. In the last decade, the demand for worldwide audiovisual data transmission has led to the standardization of telecommunication media. Therefore it is no longer necessary to transport medical data (or even patients) by conventional manners, e.g., post, car, or aircraft. Telemedicine for diagnosis and management can be bidirectional in real-time, long-distance videoconferencing, in which the patient consults a specialist located at the remote site, or it can be the transmission of either real-time or pre-recorded images and data to a remote expert, as in teleradiology or telepathology. Another application is the use of videoconference systems in the course of meetings. The remote specialist has the opportunity to take part in the session, e.g., with a lecture. Furthermore, the remote specialist can demonstrate special operative techniques for teleteaching purposes, some of which may be specialities of the particular medical unit, e.g., operation in open NMR, telemanipulation, or telerobotic procedures. In this paper, we describe the use and benefit of a videoconference between the departments of otolaryngology and head and neck surgery of the Universities of Tübingen and Leipzig by means of an "ISDN-based videoconference system". During the meeting, the "operating course for reconstructive surgery in the head and neck", the practicability, reliability, costs and quality were determined and compared with other technologies for audiovisual data transfer.