Can telepsychiatry replace in-person psychiatric assessments? A review and meta-analysis of comparison studies
Can telepsychiatry replace in-person psychiatric assessments? A review and meta-analysis of comparison studies
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DOI：
10.1017/s109285290002277x
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发表时间：
2005-05-01
期刊：
影响因子：
3.3
通讯作者：
Batchelder, ST
中科院分区：
文献类型：
--
作者：
Hyler, SE;Gangure, DP;Batchelder, ST
目的：作者进行了审查和荟萃分析的文献比较telepsychiatry与“在人”精神病assessments.Method：约380研究telepsychiatry发表于1956年和2002年之间确定使用MEDLINE，PsycINFO，和交叉引用的参考书目。其中，14项研究（N > 10）使用客观评估工具或满意度工具比较了远程精神病学与面对面精神病学（I-P）。其中三项研究比较了高带宽（HB）与低带宽（LB）telepsychiatry.Results：14项研究的500例患者符合纳入标准，并被纳入荟萃分析。在使用客观评估的研究中，发现远程精神病学与I-P相似。影响大小平均相当小，这表明远程精神病学和IP之间没有差异。带宽被发现是一个显着的主持人。三个主持人进行了测试，效果大小仍然在很大程度上异质性，需要进一步分析，以确定效果的方向。HB组和LB组之间的I-P和远程精神病学之间没有差异，尽管有轶事数据表明HB在需要对受试者进行详细观察的评估方面略优于上级。在过去40多年发表的大量远程精神病学文献中，只有少数研究试图将远程精神病学与I-进行比较P直接使用标准化的评估工具，允许有意义的比较。然而，在这些研究中，目前的荟萃分析得出结论，两种模式之间的准确性或满意度没有差异。在接下来的几年里，我们预计远程精神病学将在某些研究和临床情况下取代I-P。
Objective: The authors conducted a review and meta-analysis of the literature comparing telepsychiatry with "in-person" psychiatric assessments.Method: Approximately 380 studies on telepsychiatry published between 1956 and 2002 were identified using MEDLINE, PsycINFO, and cross-referenced bibliographies. Of these, 14 studies with an N > 10 compared telepsychiatry with in-person psychiatry (I-P) using objective assessment instruments or satisfaction instruments. Three of these studies compared high bandwidth (HB) with low bandwidth (LB) telepsychiatry.Results: Fourteen studies of 500 patients met inclusion criteria and were included in the meta-analysis. Telepsychiatry was found to be similar to I-P for the studies using objective assessments. Effect sizes were on average quite small, suggesting no difference between telepsychiatry and I-P. Bandwidth was found to be a significant moderator. Three moderators were tested, effect sizes remained largely heterogeneous, and further analyses are needed to determine the direction of effect. There was no difference between I-P and telepsychiatry between the HB and LB groups, although there are anecdotal data suggesting that HB was slightly superior for assessments requiring detailed observation of subjects.Conclusion: Out of a large telepsychiatry literature published over the past 40+ years, only a handful of studies have attempted to compare telepsychiatry with I-P directly using standardized assessment instruments that permit meaningful comparisons. However, in those studies, the current meta-analysis concludes there is no difference in accuracy or satisfaction between the two modalities. Over the next few years, we expect telepsychiatry to replace I-P in certain research and clinical situations.