Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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Telemedicine journal and e-health : the official journal of the American Telemedicine Association
Utilization of Telemedicine Among Offshore Health Care Workers and Its Influencing Factors
INTRODUCTION: Telemedicine has become an essential tool for providing health care to offshore workers. Despite its advancements, there is still a lack of understanding about its optimal use and the factors affecting it among health care providers in offshore settings. The objective of this work was to study and determine the level of telemedicine utilization among offshore health care workers and its associated factors in Malaysia. METHODS: In this cross-sectional study, online questionnaires were distributed to health care workers involved in offshore medical services. The questionnaire includes sociodemographic information and the validated Malay version of the Telemedicine Acceptance Model (TAM) Questionnaire. A total of 73 offshore health care workers were recruited from a local company using universal sampling. Data analysis involved descriptive statistics as well as simple and multiple logistic regression. RESULTS: A total of 65.8% of offshore health care workers reported using telemedicine in their practice. Multiple logistic regression analysis indicated that Chinese and Indian workers were significantly more likely to use telemedicine compared with Malay workers, with adjusted odds ratios of 32.11 (p = 0.045) and 33.51 (p = 0.037), respectively. Workers with a good attitude toward telemedicine had 11.84 times higher odds of utilization (p = 0.004), while those with high behavioral intention were 25.80 times more likely to use telemedicine compared with their counterparts with low behavioral intention (p < 0.001). CONCLUSIONS: A majority of offshore health care workers utilize telemedicine, with Chinese and Indian ethnicity, good attitude, and high behavioral intention significantly predicting its utilization.
3 July 2026
Read appraisal →Physiology (Bethesda, Md.)
Wearable Sensing for Clinical Physiology Monitoring: Emerging Paradigms
Advances in wearable sensing technology are driving a new era of personalized health monitoring. In contrast to the hard, rigid form factors of conventional wearable sensors, these emerging skin-interfaced systems support high-quality physiological measurements across biophysical, biochemical, and kinematic signals of interest. These platforms enable continuous monitoring of complex physiological processes with unprecedented detail as a result of a seamless, conformal skin interface and advanced wireless communications capabilities. These platforms integrate flexible materials, miniaturized electronics, and wireless communication to provide detailed physiological data during daily activities. This review examines how skin-interfaced wearables are advancing patient care, remote monitoring, and large-scale health studies. We highlight critical barriers to clinical adoption including interpreting data, validating devices, and integration into health care systems. Key opportunities include sustainable manufacturing, point-of-care fabrication, and development of disease-specific digital biomarkers. By addressing these challenges through collaboration among engineers, clinicians, and data scientists, wearable sensors can expand patient access to advanced physiological monitoring and transform personalized medicine.
2 July 2026
Read appraisal →Journal of special operations medicine : a peer reviewed journal for SOF medical professionals
Telemedicine Consultation: Lessons Learned from the Pararescue Experience
BACKGROUND: Telemedicine is a critical military medicine capability in austere, remote, and denied environments where prolonged casualty care and knowledge gaps exist. Despite significant military investment in telemedicine, the literature lacks detailed lessons from real-world cases. METHODS: U.S. Air Force Pararescue missions between 1 January 2010 and 31 December 2020 that included telemedicine consultation were reviewed. Participating flight surgeons (FS) and Pararescuemen (PJ) were interviewed, and available after-action reports were analyzed. Mission parameters, outcomes, and technical or human factors affecting communication were evaluated. RESULTS: Across 13 telemedicine consultations, the 28 patients experienced: cave entrapment (13), trauma (7), burns (4), and illness (4). Consultations were from PJ to FS (11), U.S. Coast Guard to FS (1), and FS to neurosurgery (1). Secondary consultations (7) were from FS to dental (1), dermatology, burn/critical care, orthopedics (2), pediatric anesthesiology, and thoracic surgery specialists. Missions used voice over mobile or satellite phone, text, and email. Recommendations commonly involved medication selection (6), advisement against mission launch (3), and burn care (2). Consultation effectiveness was impacted by unclear directions (3) and degraded communications (2). CONCLUSION: Telemedicine is valuable to PJs during complicated cases and rarely performed procedures, but cannot replace pre-deployment medical exposure and training. Rehearsals may optimize telemedicine, and training should focus on synchronizing a shared mental model of the patient using well-understood patient report and evaluation tools (ATMIST and MARCH PAWS). Telemedicine may reduce human error, give medics the confidence to take action, and limit the psychological impact of difficult care decisions.
29 June 2026
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