Evidence-Based Medicine

Research Appraisals

Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.

Showing 3 appraisals

Systematic ReviewEvidence: Weak
20CEBM

European journal of pediatrics

Telemedicine in pediatrics: a critical narrative review of innovations, limitations, and future priorities

UNLABELLED: This narrative review synthesizes recent technological and organizational developments in pediatric telemedicine, maps their principal clinical applications, and critically discusses implementation, safety, equity, and future priorities. This narrative review used a transparent, non-systematic literature-search approach in PubMed/MEDLINE, Scopus, and Google Scholar, considering publications available through April 2026. Searches were intended to identify and contextualize relevant literature across pediatric settings rather than to provide an exhaustive, reproducible systematic evidence synthesis. No formal risk-of-bias assessment, meta-analysis, or certainty-of-evidence grading was undertaken; therefore, findings are interpreted cautiously and according to the maturity and consistency of the available evidence. Evidence suggests that telemedicine can support follow-up, access to specialist care, and family engagement in several pediatric chronic-care pathways, particularly diabetes and asthma. However, the evidence base is heterogeneous across specialties, frequently relies on observational or implementation studies, and is less mature for acute assessment, neonatal and rehabilitation uses, wearables, and AI-enabled tools. CONCLUSION: Telemedicine should be considered a complementary component of pediatric healthcare rather than a replacement for in-person assessment. Hybrid models may support accessibility, continuity, and sustainability when embedded in structured, patient-centered, equitable, and clinically appropriate pathways. WHAT IS KNOWN: • Telemedicine expanded rapidly in pediatrics during the COVID-19 pandemic and is now used across many specialties. • It can improve access, continuity of care, remote monitoring, and family engagement, especially in chronic and complex conditions. WHAT IS NEW: • This review summarizes recent technological and organizational innovations, including wearables, mHealth, EHR integration, AI, and hybrid care models. • It highlights current limits and future requirements for safe, equitable, and sustainable integration into routine pediatric care.

2 Aug 2026

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Randomised Controlled TrialEvidence: Insufficient
15CEBM

Journal of global health

Leapfrogging medical infrastructure: a novel bilateral exchange model driven by digital medicine in Kazakhstan.

The geographic maldistribution of highly specialised neurosurgical care in Central Asia, particularly Kazakhstan, presents a critical challenge driven by medical education pipeline constraints and brain drain. Traditional assistance models relying on short-term missions or conventional hardware donations are insufficient to bridge this fundamental infrastructural gap. We present a novel 'Bilateral Medical Exchange Model' established between Showa Medical University in Japan and top Kazakh medical institutions. By utilising advanced digital medicine - specifically, high-performance computing-driven artificial intelligence and 3D extended reality visualisation - as the primary diplomatic catalyst, this framework successfully engaged both grassroots clinicians and top-tier government officials. We highlight how targeting these technologies toward localised capacity building and edge-computing infrastructure circumvents traditional barriers. While long-term clinical outcomes remain to be systematically evaluated, this technology-driven diplomatic approach provides a foundational, hypothesis-generating framework for bridging the digital divide, integrating digital innovation with decentralised education to ultimately improve equitable patient outcomes in transitioning economies.

6 July 2026

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Systematic ReviewEvidence: Weak
15CEBM

Medical science monitor : international medical journal of experimental and clinical research

Advances in Remote Monitoring Technology Applications in Anesthesia: A Narrative Review

The swift progress of digital and sensor technologies is hastening the incorporation of remote monitoring into anesthesiology. While several reviews have explored telemedicine and artificial intelligence in anesthesia, most existing summaries either focus on conceptual outlook or lack systematic comparison of technical platforms and original clinical validation data. The present review provides a comprehensive, clinically oriented synthesis of remote monitoring in anesthesia, with clear focuses on technical principles, perioperative applications, platform comparisons, and evidence-based clinical outcomes. We critically assess clinical advantages and implementation hurdles, covering the full perioperative pathway - preoperative evaluation, intraoperative observation, and postoperative recovery. A head-to-head comparison of fifth generation of cellular network technology (5G), the Internet of Things (IoT), and cloud computing platforms is presented to clarify their infrastructure demands and suitability for real-world clinical scenarios. Notably, this review summarizes available clinical evidence, including evidence from the Trial of Remote Continuous versus Intermittent National Early Warning Score Monitoring after major surgery (TRaCINg) - a feasibility randomized controlled trial whose exploratory findings suggest that continuous remote monitoring may reduce unplanned intensive care unit admissions, shorten hospital stays, and facilitate earlier detection of postoperative complications. We further propose innovative solutions including multimodal data fusion and federated learning-driven predictive analytics to overcome current limitations in data interoperability, security, and clinical effectiveness. Accordingly, this paper synthesizes the latest advances in remote monitoring technology in anesthesia, clarifies its unique value relative to existing reviews, and provides practical guidance for clinical translation and future research.

2 July 2026

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