Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 3 appraisals
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
Read appraisal →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
Read appraisal →Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
Telemedicine for headache disorders in real-world practice: from patient experience to health system impact.
BACKGROUND: Telemedicine has expanded rapidly in neurological care and is increasingly applied to headache management to improve access and continuity of follow-up. However, patient experience and healthcare system impact in real-world practice remain insufficiently explored. OBJECTIVE: The objective of this narrative review is to evaluate clinical effectiveness, patient experience, and healthcare system impact in the management of headache disorders. METHODS: A narrative review of the literature was conducted, including randomized controlled trials, observational studies, real-world evidence contributions, and reviews addressing telemedicine in headache care. Evidence was synthesized thematically, focusing on clinical outcomes, patient acceptance, and implementation aspects. RESULTS: Available evidence supports the clinical effectiveness and safety of telemedicine in selected headache patients, particularly in non-acute settings and structured follow-up pathways. Outcomes assessed using validated instruments (HIT-6, MIDAS, VAS) are generally comparable to in-person visits. High patient satisfaction and willingness to continue telemedicine are consistently reported, mainly due to convenience and time and cost savings. Real-world studies suggest telemedicine may improve access to specialist care and optimize healthcare resource utilization, although challenges related to digital literacy, organizational requirements, and equity remain. CONCLUSIONS: Telemedicine is a valuable component of contemporary headache management when integrated into structured clinical pathways. Beyond clinical effectiveness, patient experience and organizational context are critical for successful implementation. Future research should focus on standardized care models, larger populations, and long-term real-world outcomes.
5 July 2026
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