Telemedicine Consultations in Pediatrics — the Structure and Analysis

V. Tatochenko, M. Bakradze, G. S. Vershinin, A. Babayan
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Abstract

Aim: To analyze the content of requests for telemedicine consultations (TMC), received by the National Medical Research Center for Children's Health, and suggest possible steps to perfect it. Design: Retrospective study. Material and methods. We analyzed the content of 167 TMC requests for patients with “general pediatric profile” received in 2021 and 2022. Results. Among requests for TMC the majority (43.1%) were for “non-explainable” fever in adolescents 9–17 years of age — with clear signs of a fictitious fever. Similar number of requests were for children with a low grade fever (37,0–37,5°C) that had been vainly investigated to find out the disease causing it. Of 4 children with Kawasaki syndrome only in one it had been suspected at the late stage. Requests for respiratory disease (37.1%) were mostly for their chronic forms. Pediatricians seem not to be conversant with chronic food aspiration syndromes’ diagnosis and management, including that in patient with neurologic conditions. Rare disease and/or unusual symptoms, as well as management of problem patients with known disease were less often the subject of TMC (12 и 7.8% respectively). Conclusion. We could state that pediatric hospitals have extensive diagnostic potential — except bacteriology that has to be upgrade. At the same time there is a tendency of pediatricians to conduct in problem cases multiple non-directional analyses and investigations, incorrectly interpret their results, as well as voluntarily formulate diagnoses. There is a need to do away with excessive and non-recommended use of antibiotics, IV infusion of “desintoxication” solutions, as well as polypharmacy. For the improvement of TMC it seems important to foresee the inclusion into TMS requests data on the disease progression as well as on the dynamics of relevant clinical and paraclinical parameters; the results of analyses and instrumental investigations should be put into addendum. There should be a feedback mechanism — a response to TMC with an appraisal of its effectivity. Keywords: telemedicine, telemedicine consultations in pediatrics.
儿科远程医疗会诊的结构与分析
目的:对国家儿童健康医学研究中心收到的远程医疗会诊请求内容进行分析,并提出完善建议。设计:回顾性研究。材料和方法。我们分析了2021年和2022年收到的167份针对“普通儿科”患者的TMC请求的内容。结果。在TMC的请求中,大多数(43.1%)是针对9-17岁青少年的“无法解释的”发烧-有明显的虚构发烧迹象。同样数量的请求是针对低烧(37,0 - 37,5°C)的儿童,对其进行了徒劳的调查,以找出引起低烧的疾病。在4名患有川崎综合征的儿童中,只有1人在晚期被怀疑患有川崎综合征。呼吸道疾病(37.1%)主要是慢性疾病。儿科医生似乎不熟悉慢性食物吸入综合征的诊断和管理,包括神经系统疾病患者的诊断和管理。罕见疾病和/或异常症状以及已知疾病的问题患者的管理较少成为TMC的主题(分别为12.7.8%)。结论。我们可以说,儿科医院有广泛的诊断潜力——除了必须升级的细菌学。与此同时,儿科医生对问题病例进行多次无方向性分析和调查,错误地解释其结果,以及自愿制定诊断的趋势。有必要取消过度使用和不推荐使用抗生素、静脉输注“解毒”溶液以及多种用药。为了改善TMC,预计将疾病进展以及相关临床和临床旁参数的动态数据纳入TMS请求似乎很重要;分析和仪器调查的结果应列入附录。应该有一个反馈机制——对TMC作出回应,并对其有效性进行评估。关键词:远程医疗;儿科远程医疗会诊;
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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