背景:对新型数字健康技术(DHT)进行深入的科学评估是促进成功开发和实施的关键。因此,我们之前开发了电子健康评估周期。电子健康评估周期包含5个连续的研究阶段:概念,发展,可行性,有效性,和执行。
目的:本研究的目的是更好地了解电子健康评估周期的日常实践。因此,目标是对文献资料进行结构化分析,以分析评估研究阶段的实践,并确定在电子健康评估周期的哪个研究阶段使用哪种评估方法.
方法:我们在PubMed中进行了系统的文献检索,包括MeSH术语“远程医疗”以及多种评估方法。纳入了2019年发表的原始同行评审研究(COVID-19之前的队列)。非患者重点研究被排除。提取并系统分析了以下变量的数据:期刊,国家,出版日期,医学专业,主要用户,功能,评估研究阶段,和评价方法。RStudio软件用于总结描述性数据并进行统计分析。
结果:我们纳入了824项研究,筛选了1583项标题和摘要。大多数评估研究集中在有效性(影响;304/824,36.9%)研究阶段,而摄取(实施;70/824,8.5%)得到的焦点最少。最常用的DHT评价方法是随机对照试验(RCTs;170/899,18.9%)。在有效性(影响)研究阶段,在一半的研究中使用了RCT。在概念和规划阶段,使用频率最高的是调查研究(27/78,35%)和访谈研究(27/78,35%)。美国发表的DHT评价研究最多(304/824,36.9%)。精神病学和心理健康(89/840,10.6%)和心脏病学(75/840,8.9%)在该领域发表了大部分研究。
结论:我们对实施连续DHT评估研究阶段的实际实践进行了第一次全面概述。我们发现,对电子健康评估周期的研究阶段进行了不平等的研究,并且最关注的是有效性研究阶段。此外,大多数研究采用RCT设计.然而,为了成功开发和实施新型DHT,刺激对DHT顺序研究阶段的平等评估,并选择适合技术迭代性质的正确评估方法可能是至关重要的。
BACKGROUND: Profound scientific evaluation of novel digital health technologies (DHTs) is key to enhance successful development and implementation. As such, we previously developed the eHealth evaluation cycle. The eHealth evaluation cycle contains 5 consecutive study phases: conceptual, development, feasibility, effectiveness, and implementation.
OBJECTIVE: The aim of this study is to develop a better understanding of the daily practice of the eHealth evaluation cycle. Therefore, the objectives are to conduct a structured analysis of literature data to analyze the practice of the evaluation study phases and to determine which evaluation approaches are used in which study phase of the eHealth evaluation cycle.
METHODS: We conducted a systematic literature search in PubMed including the MeSH term \"telemedicine\" in combination with a wide variety of evaluation approaches. Original peer-reviewed studies published in the year 2019 (pre-COVID-19 cohort) were included. Nonpatient-focused studies were excluded. Data on the following variables were extracted and systematically analyzed: journal, country, publication date, medical specialty, primary user, functionality, evaluation study phases, and evaluation approach. RStudio software was used to summarize the descriptive data and to perform statistical analyses.
RESULTS: We included 824 studies after 1583 titles and abstracts were screened. The majority of the evaluation studies focused on the effectiveness (impact; 304/824, 36.9%) study phase, whereas uptake (implementation; 70/824, 8.5%) received the least focus. Randomized controlled trials (RCTs; 170/899, 18.9%) were the most commonly used DHT evaluation method. Within the effectiveness (impact) study phase, RCTs were used in one-half of the studies. In the conceptual and planning phases, survey research (27/78, 35%) and interview studies (27/78, 35%) were most frequently used. The United States published the largest amount of DHT evaluation studies (304/824, 36.9%). Psychiatry and mental health (89/840, 10.6%) and cardiology (75/840, 8.9%) had the majority of studies published within the field.
CONCLUSIONS: We composed the first comprehensive overview of the actual practice of implementing consecutive DHT evaluation study phases. We found that the study phases of the eHealth evaluation cycle are unequally studied and most attention is paid to the effectiveness study phase. In addition, the majority of the studies used an RCT design. However, in order to successfully develop and implement novel DHTs, stimulating equal evaluation of the sequential study phases of DHTs and selecting the right evaluation approach that fits the iterative nature of technology might be of the utmost importance.