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Telehealth and telemedicine applications for the diabetic foot: A systematic review
Author(s) -
Hazenberg Constantijn E. V. B.,
Stegge Wouter B.,
Van Baal Sjef G.,
Moll Frans L.,
Bus Sicco A.
Publication year - 2020
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3247
Subject(s) - telehealth , medicine , telemedicine , modalities , randomized controlled trial , physical therapy , medline , cost effectiveness , intensive care medicine , foot (prosody) , diabetic foot , medical physics , physical medicine and rehabilitation , health care , surgery , diabetes mellitus , risk analysis (engineering) , social science , linguistics , philosophy , sociology , political science , law , economics , economic growth , endocrinology
Summary The aim of this systematic review is to assess the peer‐reviewed literature on the psychometric properties, feasibility, effectiveness, costs, and current limitations of using telehealth and telemedicine approaches for prevention and management of diabetic foot disease. MEDLINE/PubMed was searched for peer‐reviewed studies on telehealth and telemedicine approaches for assessing, monitoring, preventing, or treating diabetic foot disease. Four modalities were formulated: dermal thermography, hyperspectral imaging, digital photographic imaging, and audio/video/online communication. Outcome measures were: validity, reliability, feasibility, effectiveness, and costs. Sixty‐one studies were eligible for analysis. Three randomized controlled trials showed that handheld infrared dermal thermography as home‐monitoring tool is effective in reducing ulcer recurrence risk, while one small trial showed no effect. Hyperspectral imaging has been tested in clinical settings to assess and monitor foot disease and conflicting results on its diagnostic use show that this method is still in an experimental stage. Digital photography is used to assess and monitor foot ulcers and pre‐ulcerative lesions and was found to be a valid, reliable, and feasible method for telehealth purposes. Audio/video/online communication is mainly used for foot ulcer monitoring. Two randomized controlled trials show similar healing efficacy compared with regular outpatient clinic visits, but no benefit in costs. In conclusion, several technologies with good psychometric properties are available that may be of benefit in helping to assess, monitor, prevent, or treat diabetic foot disease, but in most cases, feasibility, effectiveness, and cost savings still need to be demonstrated to become accepted and used modalities in diabetic foot care.