Metrics for Evaluating Telemedicine in Randomized Controlled Trials: Scoping Review

Area of Science:

• Healthcare Technology
• Clinical Research Methodology
• Health Services Research

Background:

• Telemedicine utilizes telecommunication technology for medical services, improving patient quality of life and disease management.
• Despite IT advancements, a clear understanding of telemedicine's utility and limitations in randomized controlled trials (RCTs) is lacking.
• Standardized, cross-disciplinary metrics for comparing telemedicine and in-person care in RCTs are undefined.

Purpose of the Study:

• To review general and cross-disciplinary metrics used in RCTs comparing telemedicine with in-person care.
• To identify previously unevaluated indicators for telemedicine research.
• To recommend prioritized indicators for future clinical trials.

Main Methods:

• Systematic review of MEDLINE and Embase databases.
• Inclusion of original, English-language RCTs comparing telemedicine and face-to-face care from January 2019 to March 2024.
• Summarization of basic information and general metrics from included studies following PRISMA-ScR guidelines.

Main Results:

• 79 RCTs were analyzed, revealing common metrics in three categories: patient-centeredness (85%), patient outcomes (72%), and cost-effectiveness (51%).
• Only 32% of studies evaluated all three core categories.
• Less frequently evaluated metrics include staff convenience (10%), system usability (4%), and environmental impact (3%).

Conclusions:

• Significant variation exists in telemedicine evaluation metrics across studies.
• General indicators are recommended alongside disease-specific ones for broader understanding.
• Future trials should comprehensively assess patient-centeredness, patient outcomes, and cost-effectiveness, incorporating metrics like staff convenience, system usability, and environmental impact.
• Standardization of evaluation metrics is essential for future telemedicine research.