Understanding virtual urology clinics: a systematic review.
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
OBJECTIVE: To perform a systematic review to identify the clinical, fiscal and environmental evidence on the use of urological telehealth and/or virtual clinic strategies. Our secondary aim was to highlight research gaps in this rapidly evolving field. METHODS: Our PROSPERO registered (CRD42019151946) systematic search of Embase, Medline and Cochrane Review Database was performed for original research articles pertaining to adult urology telehealth or virtual clinic strategies. Risk of bias (RoB) assessment performed according to Cochrane 2.0 RoB or Joanna Briggs Institute Checklist for non-randomised studies. RESULTS: 5,813 participants met inclusion from 18 original articles (2 randomised controlled trials; 10 prospective; 6 retrospective). Urology sub-specialities: Uro-oncology (n=6), General urology (n=8), Endo-urology (n=2), and Lower urinary tract symptoms and/or incontinence (n=2). Across all sub-specialties, prospective studies utilising VC reported: primary median VC discharge rate of 16.6% (IQR 14.7%-29.8%) and primary median face-to-face (FTF) clinic referral rate of 32.4% (IQR 15.5%-53.3%). Further, direct cost analysis demonstrated a median annual cost-savings of £56,232 (IQR £46,260-£61,116). Grade II and IIIb complications were reported in two acute ureteric colic studies, with a rate of 0.20% (3/1,534) and 0.13% (2/1,534), respectively. Annual carbon footprint avoided ranged from 0.7 to 4.35 metric tonnes of CO2 emissions, depending on mode of transport utilised. Patient satisfaction was inconsistently reported, and assessments lacked prospective evaluation using validated questionnaires. CONCLUSION: Virtual urology clinics are a promising new platform which can offer clinical, financial and environmental benefits to support an increasing urological referral burden. Further prospective evidence is required across urological subspecialties to confirm equivalency and safety against traditional face-to-face assessment.
Date Issued
2020-11
Date Acceptance
2020-05-01
Citation
BJU International, 2020, 126 (5), pp.536-546
ISSN
1464-4096
Publisher
Wiley
Start Page
536
End Page
546
Journal / Book Title
BJU International
Volume
126
Issue
5
Copyright Statement
© 2020 The Authors BJU International published by John Wiley & Sons Ltd on behalf of BJU International
This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License http://creativecommons.org/licenses/by-nc-nd/4.0/, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License http://creativecommons.org/licenses/by-nc-nd/4.0/, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Sponsor
Wellcome Trust
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/32463991
Grant Number
204998/Z/16/Z
Subjects
carbon footprint
prostate cancer
telehealth
telemedicine
ureteric colic
urology virtual clinic
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2020-05-28