• Carolina Dutra Queiroz Flumignan, RochaAline Pereira daAPD0000-0002-0863-6500MSc. Pharmacist and Doctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), and Volunteer Researcher, Cochrane Brazil, São Paulo (SP), Brazil., PintoAna Carolina Pereira NunesACPN0000-0002-1505-877XMSc. Physiotherapist and Doctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP); Professor, Department of Biological and Health Sciences, Universid, Keilla Machado Martins Milby, Mayara Rodrigues Batista, Álvaro Nagib Atallah, and Humberto Saconato.
• MD, PhD. Postdoctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), and Volunteer Researcher, Cochrane Brazil, São Paulo (SP), Brazil.
• Sao Paulo Med J. 2019 Jul 15; 137 (2): 184192184-192.

BackgroundTelemedicine has emerged as a tool for overcoming the challenges of healthcare systems and is likely to become increasingly viable, since information and communication technologies have become more sophisticated and user-friendly.ObjectiveWe aimed to identify all Cochrane systematic reviews (CSRs) on telemedicine within healthcare and to summarize the current evidence regarding its use.Design And SettingReview of CSRs, developed at the Discipline of Emergency and Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo.MethodsWe searched for studies that compared use of telemedicine with conventional treatment or management of diseases within healthcare. Diagnostic telemedicine studies or studies using automatic text, voice-text or even self-managed care were excluded. The main characteristics and the certainty of evidence were synthetized and critically discussed by all authors.ResultsWe included 10 CSRs that investigated a broad range of diseases. There is still insufficient evidence to determine what types of telemedicine interventions are effective, for which patients and in which settings, and whether such interventions can be used as a replacement for the standard treatment. Harm relating to telemedicine technologies needs to be better investigated and addressed.ConclusionTelemedicine might be an excellent way to facilitate access to treatment, monitoring and dissemination of important clinical knowledge. However, given the recognition of systematic reviews as the best evidence resource available for decision-making, further randomized controlled trials with stricter methods are necessary to reduce the uncertainties in evidence-based use of telemedicine.

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