Video-observed therapy (VOT) vs directly observed therapy (DOT) for tuberculosis treatment: A systematic review on adherence, cost of treatment observation, time spent observing treatment and patient satisfaction.

INTRODUCTION: Tuberculosis (TB) treatment demands strict adherence to multidrug regimens. Directly Observed Therapy (DOT) poses challenges, especially regarding adherence. With the popularization of smartphones, Video-Observed Therapy (VOT) has emerged as a promising alternative, allowing healthcare providers to remotely supervise patients taking their medications via video calls. OBJECTIVES: This systematic review critically assesses VOT's effectiveness compared to DOT, focusing on adherence, treatment costs, time spent supervising treatment, and patient satisfaction, aiming to optimize TB supervision methods worldwide. METHODS: Only studies that met the following criteria were eligible for inclusion in the systematic review: randomized trials; studies that compared VOT to DOT; studies involving patients diagnosed with pulmonary or extrapulmonary tuberculosis; studies that reported any of the desired outcomes; full-text articles available for review; and studies conducted in the English language. We excluded studies with the following attributes: studies that lacked a control group; case series or case reports; and previous systematic reviews. The search engines and databases MEDLINE, Embase, and Cochrane were used to find studies comparing Video-Observed Therapy (VOT) to Directly Observed Therapy (DOT). The following search phrases were used to look for papers that contained them in their title or abstract: ("Electronic Directly Observed Therapy" OR "Video-observed therapy" OR "Telemedicine" OR "Wirelessly observed therapy" OR "Smartphone-enabled video-observed") AND ("TUBERCULOSIS"). RESULTS: A systematic review of the literature revealed the following findings: in all Randomized Controlled Trials (RCTs), video-observed therapy (VOT) demonstrated non-inferiority in terms of treatment adherence compared to traditional directly observed therapy (DOT); VOT reduced costs where these outcomes were assessed in the RCTs; the use of VOT reduced the amount of time healthcare professionals spent supervising treatment in RCTs evaluating this aspect; VOT contributed to higher treatment satisfaction in RCTs where this outcome was measured. CONCLUSION: In this systematic review we emphasize the importance of Video-Observed Therapy (VOT) in the digital age for patients that have access to internet. Our findings show that VOT is comparable to DOT in terms of treatment adherence, but it is also cost-effective, improves patient satisfaction and takes less time for healthcare professionals to supervise.

Cross-cultural adaptation of the eHealth Literacy Scale for Brazilian adolescents.

The aim of this study was to undertake a cross-cultural adaptation of the eHealth Literacy Scale (eHEALS) instrument to measure digital health literacy of Brazilian adolescents. eHEALS is a scale consisting of 8 items that measure self-perception related to the consumption of electronic health information. This is a methodological study of cross-cultural adaptation, conducted out from February 2022 to June 2022. The following steps were carried out: a) assessment and adequacy of cultural equivalence by a committee of experts; b) back-translation; c) synthesis of back-translations; d) cognitive testing with 42 Brazilian adolescents, using cognitive interviews with probing questions. All items that were difficult to understand were adapted to the (language) context of Brazilian adolescents. Cronbach's alpha coefficient for eHEALS-BrA was 0.81 and, if one of the items were excluded from the instrument, it ranged from 0.75-0.81. This version of the eHEALS proved to be culturally well-adapted to the context of Brazilian adolescents, and has the potential to measure digital health literacy in this population after having its validation confirmed through psychometric analyses.

Translation and cross-cultural adaptation of the Telemedicine Satisfaction Questionnaire for use in Brazil.

OBJECTIVE: To translate, cross-culturally adapt to Brazilian Portuguese, and evaluate the reliability of the Telemedicine Satisfaction Questionnaire (TSQ). METHODS: This cross-sectional study involved patients from the Smoking Prevention and Cessation Center (PrevFumo) who participated in at least four of the eight scheduled remote meetings with the PrevFumo psychologist in 2020, 2021, or 2022. Participants were contacted by telephone and asked to answer the 14 questions of the TSQ three times at intervals of 7 or 10 days. RESULTS: We assessed 53 patients (73.3% women). The mean age was 49.7 ± 10.2 years. The mean smoking history was 35.32 ± 24.8 pack-years. Of the 53 patients evaluated, 30.2% had completed high school or had some higher education, and 32.1% were classified as socioeconomic class B2 (A being the highest and E being the lowest). Forty-nine (92.5%) of the patients attended all eight meetings. The TSQ with only three answer options showed high reliability, with approximately 90% agreement after three applications. Patients were satisfied with telemedicine. CONCLUSIONS: The TSQ is rapidly applied, is easy to complete, and showed high reliability in our patient sample. Patients declared that they were satisfied with their telemedicine experience.

First impressions of Telesurgery robotic-assisted radical prostatectomy using the Edge medical robotic platform.

PURPOSE: We reported, as a referral center in prostate cancer, our perspectives and experience performing Telesurgery using robotic surgery and 5G network. MATERIAL AND METHODS: We described and illustrated the Telesurgery applications and outcomes to treat a patient with prostate cancer located 1300 kilometers away from the surgeon (Beijing-Harbin) in China. We used the Edge Medical Robot (MP1000) in November 2023 in a 71-year-old patient with Gleason 6 (ISUP 1) in 8 cores from 13, PSA of 14 ng/dL, and clinical stage cT2a. MRI described a PIRADS 5 nodule on the left peripheral zone at the base, and 20gr prostate. We described details about the connection between centers, perioperative outcomes, and our perspectives as a referral center in prostate cancer. RESULTS: We had no delays, or problems with network connection between the centers. The procedure was performed in 60 minutes, with no intra- or postoperative complications. Estimated blood loss was 100 mL. The patient was ambulating soon after anesthesia recovery. Final pathology described a Gleason 6 (ISUP 1) involving the left base and left seminal vesicle, negative surgical margins, and no lymph node involvement (pT3bN0). The patient was continent soon after catheter removal (7 days). CONCLUSION: As technological progress introduced novel robotic platforms and high-speed networks, the concept of Telesurgery became a tangible reality while 5G technology solved latency and transmission concerns. However, with these advancements, ethical considerations and regulatory frameworks should underline the importance of transparency and patient safety with responsible innovation in the field.

Assessment of a Pilot Program for Remote Support on Mental Health for Young Physicians in Rural Settings in Peru: Mixed Methods Study.

BACKGROUND: Telemedicine-based interventions show promise in addressing mental health issues among rural populations, yet evidence regarding their impact among the health care workforce in these contexts remains limited. OBJECTIVE: This study aimed to evaluate the characteristics and the responses and perceptions of recently graduated physicians who work in rural areas of Peru as part of the Servicio Rural Urbano Marginal en Salud (Rural-Urban Marginal Health Service [SERUMS], in Spanish) toward a telehealth intervention to provide remote orientation and accompaniment in mental health. METHODS: A mixed methods study was carried out involving physicians who graduated from the Universidad Nacional Mayor de San Marcos and participated in the Mental Health Accompaniment Program (MHAP) from August 2022 to February 2023. This program included the assessment of mental health conditions via online forms, the dissemination of informational materials through a website, and, for those with moderate or high levels of mental health issues, the provision of personalized follow-up by trained personnel. Quantitative analysis explored the mental health issues identified among physicians, while qualitative analysis, using semistructured interviews, examined their perceptions of the services provided. RESULTS: Of 75 physicians initially enrolled to the MHAP, 30 (41.6%) opted to undergo assessment and use the services. The average age of the participants was 26.8 (SD 1.9) years, with 17 (56.7%) being female. About 11 (36.7%) reported have current or previous mental health issues, 17 (56.7%) indicating some level of depression, 14 (46.7%) indicated some level of anxiety, 5 (16.6%) presenting a suicidal risk, and 2 (6.7%) attempted suicide during the program. Physicians who did not use the program services reported a lack of advertising and related information, reliance on personal mental health resources, or neglect of symptoms. Those who used the program expressed a positive perception regarding the services, including evaluation and follow-up, although some faced challenges accessing the website. CONCLUSIONS: The MHAP has been effective in identifying and managing mental health problems among SERUMS physicians in rural Peru, although it faced challenges related to access and participation. The importance of mental health interventions in this context is highlighted, with recommendations to improve accessibility and promote self-care among participants.

Pilot implementation of a telehealth course for health professions students.

OBJECTIVES: This study examined the level of technology proficiency amongst healthcare professions students. Additionally, the study provides an evaluation of the pilot implementation, as well as the effect of a 7-module telehealth course on the level of adoption and future use of telehealth amongst future Australian healthcare workforce. METHODS: Students from four health-sciences departments at the University of Melbourne, Australia, participated in this pilot study by completing the course and an online questionnaire, which included both structured and open-ended questions. The questionnaire included: 12-items on socio-demographic and Internet utilization; 34-items about acceptance and use of telehealth adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT2) questionnaire; and 22-items about confidence in using the Internet and ICT, adapted from Technology Proficiency Self-Assessment Questionnaire for 21st Century Learning (TPSA-C-21). RESULTS: The evaluation included 26 students who expressed confidence in their Internet/ICT skills They showed enthusiasm for telehealth and recognized its potential benefits, but also emphasized the value of face-to-face interactions. They requested information on legal and aspects and additional learning. Post-test assessments indicated improvements in overall acceptance and use attitudes towards telehealth and on six dimensions of the UTAUT2 instrument. Participation in the course indicated improvements in students' overall acceptance and use attitudes and on six of the ten dimensions of the UTAUT2 instrument (p < 0.05). CONCLUSION: This preliminary evaluation indicated that the telehealth course was a positive and enjoyable learning experience for students with appropriate structure and information. The course was successful in improving students' acceptance and use of health technology. The study identified areas in which further development might be required. As such, the course represents a helpful approach for telehealth training among health professions students. Further evaluation with larger samples is required.

Analysis of the structure of Basic Health Units in Brazil to conduct telehealth actions: a comparison of two cross-sectional studies.

BACKGROUND: Telehealth uses Information and Communication Technologies (ICT) in distance health-related activities between professionals, managers, and patients of health services. This cross-sectional study compared the ICT infrastructure available in Brazilian Basic Health Units (BHU) for telehealth actions, along with evaluation cycles of the National Program for Improving Access and Quality of Primary Care (PMAQ-AB). METHODS: Data from the second and third cycles of the PMAQ-AB were used. A total of 22,021 BHUs were evaluated concerning the availability of computers, cameras, stereo boxes, microphones, printers, television, and internet available. The presence of each ICT equipment assigned a score to each BHU. The sum of these scores assigned a final score to the BHU and was used for comparison among different Brazilian regions. The data were analyzed descriptively and by Wilcoxon test (p ≤ 0.05) using SPSS v. 25. RESULTS: The increase in the median number of ICT equipment was statistically significant in the BHU in Brazil and the Brazilian regions (p < 0.001). The South, Southeast, and Midwest regions had the highest median scores in both cycles. CONCLUSIONS: The availability of ICT equipment for telehealth actions in BHU improved over the PMAQ-AB cycles, with differences in the ICT structure between Brazilian regions.

Patient Engagement With and Perceptions of the COVIDA Project, a Volunteer-Led Telemonitoring and Teleorientation Service for COVID-19 Community Management: Mixed Methods Study.

BACKGROUND: During the pandemic in Peru, the COVIDA (Collaboration Network of Volunteer Brigade Members for the Investigation, Detection, and Primary Management of Community Cases Affected by COVID-19) project proposed an innovative way to provide telemonitoring and teleorientation to COVID-19 patients, led by health care student volunteers. However, it has not been described how this interaction is perceived from the patient's perspective and which factors increase their engagement with this service. OBJECTIVE: The aim of this study is to describe the perceptions of patients about COVIDA and identify factors associated with their engagement with this service. METHODS: A mixed methods study was conducted to evaluate perceptions of patients that participated in the COVIDA project. This telehealth intervention organized by the National University of San Marcos was implemented in Peru from August to December 2020. The service involved daily phone calls by volunteer students to monitor registered COVID-19 patients until the completion of the 14th day of the illness or if a warning sign was identified. The volunteers also provided teleorientation to address the patients' needs and concerns. Quantitative analysis was performed to describe the characteristics of the patients and to assess the factors related to their engagement with the service, which was defined by the percentage of participants who completed the follow-up according to their individual schedule. Qualitative analysis through semistructured interviews evaluated the patients' perceptions of the service regarding the aspects of communication, interaction, and technology. RESULTS: Of the 770 patients enrolled in COVIDA, 422 (55.7%) were female; the median age was 39 (IQR 28-52) years. During the monitoring, 380 patients (49.4%) developed symptoms, and 471 (61.2%) showed warning signs of COVID-19. The overall median for engagement was 93% (IQR 35.7%-100%). Among those patients who did not develop warning signs, engagement was associated with the presence of symptoms (OR 3.04, 95% CI 2.22-4.17), a positive COVID-19 test at the start of follow-up (OR 1.97, 95% CI 1.48-2.61), and the presence of comorbidities (OR 1.83, 95% CI 1.29-2.59). Patients reported that the volunteers provided clear and valuable information and emotional support. Communication via phone calls took place smoothly and without interruptions. CONCLUSIONS: COVIDA represents a well-accepted and well-perceived alternative model for student volunteers to provide telemonitoring, teleorientation, and emotional support to patients with COVID-19 in the context of overwhelmed demand for health care services. The deployment of this kind of intervention should be prioritized among patients with symptoms and comorbidities, as they show more engagement with these services.

Mobile application: digital health card for deaf adolescents.

OBJECTIVE: To develop a mobile health application (mHealth) accessible to deaf adolescents, based on their health card, promoting autonomy to the access to the user's health information. METHOD: This was a methodological study, divided into three stages: a questionnaire to understand the knowledge of deaf adolescents about the health card, and development of the application using videos in Brazilian Sign Language Libras, Android Studio platform with Java language, and evaluation of the application. RESULTS: Most deaf adolescents were not aware of the health card. The application has two interface modes: male and female card, with the particularities of each sex. Furthermore, user's data security is carried out in accordance with the Brazilian General Data Protection Law. The application received a score of 85.5 from experts, being classified as "good" to "excellent" in terms of usability. CONCLUSION: The application provides information from the health card in text and video in Libras, according to the selected sex, promoting adolescents' autonomy in accessing health information. Future implementations may include expansion to other mobile platforms.

Impact of financial toxicity on adults with cancer during the COVID-19 pandemic: an integrative review.

OBJECTIVES: to identify the repercussions of financial toxicity on the lives of adult cancer patients during the COVID-19 pandemic. METHODS: an integrative review was conducted using the PubMed, Web of Science, Scopus, and Embase databases, as well as the Virtual Health Library portal, in March 2023. RESULTS: out of 62 studies found, 13 were included for analysis. The primary repercussions of financial toxicity included difficulties in covering basic expenses such as food, housing, medication, transportation, and internet access; increased anxiety and concerns related to health and financial situations; reduction or absence of income; challenges in obtaining treatment or accessing healthcare services; rising expenses; and telemedicine as a less burdensome alternative. CONCLUSIONS: the pandemic has exacerbated financial toxicity; therefore, healthcare teams must recognize it as an adverse event of oncological treatment and understand its potential to affect various aspects of patients' lives.

Together towards tomorrow: partnerships powering the digital transformation of the health sector

This editorial presents a collective vision of unity, innovation and collaboration, and a shared desire for resilient and more equitable health systems worldwide, urging the global health community to harness the collective strength of alliances and international collaboration to guide the health sector into a new era of digital transformation and innovation.

Telemedicine for the provision of medication abortion to pregnant people at up to twelve weeks of pregnancy: a systematic literature review and meta-analysis.

BACKGROUND: Telemedicine represents an important strategy to facilitate access to medication abortion (MAB) procedures, reduces distance barriers and expands coverage to underserved communities. The aim is evaluating the self-managed MAB (provided through telemedicine as the sole intervention or in comparison to in-person care) in pregnant people at up to 12 weeks of pregnancy. METHODS: A literature search was conducted using electronic databases: MEDLINE, Embase, Cochrane (Central Register of Controlled Trials and Database of Systematic Reviews), LILACS, SciELO, and Google Scholar. The search was based on the Population, Intervention, Comparison, Outcome, and Study Design (PICOS) framework, and was not restricted to any years of publication, and studies could be published in English or Spanish. Study screening and selection, risk of bias assessment, and data extraction were performed by peer reviewers. Risk of bias was evaluated with RoB 2.0 and ROBIS-I. A narrative and descriptive synthesis of the results was conducted. Meta-analyses with random-effects models were performed using Review Manager version 5.4 to calculate pooled risk differences, along with their individual 95% confidence intervals. The rate of evidence certainty was based on GRADE recommendations. RESULTS: 21 articles published between 2011 and 2022 met the inclusion criteria. Among them, 20 were observational studies, and 1 was a randomized clinical trial. Regarding the risk of bias, 5 studies had a serious risk, 15 had a moderate risk, and 1 had an undetermined risk. In terms of the type of intervention, 7 compared telemedicine to standard care. The meta-analysis of effectiveness revealed no statistically significant differences between the two modalities of care (RD = 0.01; 95%CI 0.00, 0.02). Our meta-analyses show that there were no significant differences in the occurrence of adverse events or in patient satisfaction when comparing the two methods of healthcare delivery. CONCLUSION: Telemedicine is an effective and viable alternative for MAB, similar to standard care. The occurrence of complications was low in both forms of healthcare delivery. Telemedicine services are an opportunity to expand access to safe abortion services.

Development and Testing of the WiseApp for Improving Medication Adherence Among Spanish Speakers.

There is evidence to support the use of mHealth tools for improving medication adherence. Building on this evidence, our study team culturally adapted and translated the WiseApp for improving antiretroviral medication adherence in Spanish-speaking persons with HIV. We are currently conducting a multi-site randomized controlled trial (RCT) to test the effectiveness and sustainability of the WiseApp for Spanish speakers in New York City and the Dominican Republic.

The impact of the pandemic on physical and functional disabilities in children and adolescents with spina bifida.

STUDY DESIGN: Retrospective and cross-sectional study. OBJECTIVES: The study aimed to carry out telemonitoring to identify the impact of the pandemic on physical and functional disabilities in children and adolescents with SB, as reported by their caregivers, and to investigate adherence to a teleservice. SETTING: Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP). METHODS: Retrospective and cross-sectional study. Fifty-three patients with SB (mean age 12.0 (4.0) years; 23 males) participated in the telemonitoring. A questionnaire - 'Health management, health conditions, rehabilitation, interest in teleservice, and the well-being of the main caregiver' - investigated the clinical impact of the coronavirus pandemic. Only three caregivers participated in the teleservice (video call). RESULTS: According to telemonitoring, 62% of the patients discontinued physiotherapy sessions, and 69% reported needing adjustments in locomotion devices. The main complaints were muscle weakness and pain. CONCLUSION: We monitored general health and identified demands related to physical rehabilitation using telemonitoring in 42.4% of children and adolescents with SB monitored at the HCFMRP-USP. Telemonitoring and teleservice may be methods used for monitoring health conditions in patients with SB.

Mobile solution and chronic diseases: development and implementation of a mobile application and digital platform for collecting, analyzing data, monitoring and managing health care.

BACKGROUND: Technological advances based on mobile health (mHealth), the field of digital health (eHealth) aimed at managing health services and care and their concomitant transformations, have become increasingly important in the 21st century. In this context, care for individuals diagnosed with Chronic Non-Communicable Diseases (CNCDs) deserves to be highlighted. The aim of this study is to present the creation, development and implementation of the Telehealth Center of the Federal University of Viçosa (NUTELES - UFV), for the monitoring and management of health care for individuals with Arterial Hypertension (AH) and/or Diabetes Mellitus (DM). METHODS: This study, carried out in 2022 and 2023, involved 374 patients diagnosed with AH and/or DM in the health micro-region of Viçosa/MG, Brazil, comprising nine municipalities. The research aims to describe the creation, development and implementation of a software (NutelesApp) for the collection, storage, management and analysis of epidemiological research in public health, focusing specifically, on the monitoring and management of health care for individuals with AH and/or DM monitored by Primary Health Care (PHC). The parameters collected and analyzed were obtained through a questionnaire applied to patients, consisting of 70 questions, subdivided into 12 classes of questions. The epidemiological survey data was collected using mobile devices and analyzed using computer techniques based on statistical analysis. Once the field teams had completed their work, the files were transferred to servers for general analysis processing, using estimates of means, prevalence and respective standard errors, calculated using the Statistical Package for Social Science (SPSS) program, which takes into account the planning variables and includes the basic weights resulting from the sampling process. This study was approved by the Human Research Ethics Committee and registered, prior to recruitment, by the Brazilian Registry of Clinical Trials (ReBEC), ID: RBR-45hqzmf (Last approval date: 11/30/2022). RESULTS: The information obtained through data collection with subsequent exploratory analysis of epidemiological data using the NutelesApp software suggests that mobile applications intended for the purpose of monitoring and managing healthcare for people with AH and/or DM should address the variables necessary to support a process of understanding the health conditions and/or disease of the individual as a whole and provide short- and long-term learning. Regarding the results of the survey using the software, the variables of 374 people were analyzed. Majority are female (73.2%) and white (43.5%). Most patients are elderly (average 64 years), with blood pressure levels within the normal range for this population, BMI indicates overweight, AC increased risk for cardiovascular events and CC within the recommendation value. All biochemical parameters analyzed were above normal limits. CONCLUSIONS: The description of the creation and development of the software includes practical examples of its implementation, the results collected and its applicability in real scenarios, presenting determining criteria that can provide assertive and timely interventions for monitoring and managing the health and/or disease parameters of patients with HA and/or DM. In addition, the beneficial consequences of using this application will extend to health units and their respective management, improving the services provided by PHC and enhancing strategies and actions for health promotion and disease prevention.

Digital health in stroke: a narrative review.

Digital health is significantly transforming stroke care, particularly in remote and economically diverse regions, by harnessing mobile and wireless technologies, big data, and artificial intelligence (AI). Despite the promising advancements, a notable gap exists in the formal clinical validation of many digital health applications, raising concerns about their efficacy and safety in real-world clinical settings. Our review systematically explores the landscape of digital health in stroke care, assessing the development, validation, and implementation of various digital tools. We adopted a comprehensive search strategy, scrutinizing peer-reviewed articles published between January 2015 and January 2024, to gather evidence on the effectiveness of digital health interventions. A rigorous quality assessment was conducted to ensure the reliability of the included studies, with findings synthesized to underscore key technological innovations and their clinical outcomes. Ethical considerations were meticulously observed to maintain data confidentiality and integrity. Our findings highlight the transformative potential of mobile health technologies, AI, and telemedicine in improving diagnostic accuracy, treatment efficacy, and patient outcomes in stroke care. Our paper delves into the evolution and impact of digital health in cerebrovascular prevention, diagnosis, rehabilitation and stroke treatment, emphasizing the digital health's role in enhancing access to expert care, mitigating treatment delays and improving outcomes. However, the review also underscores the critical need for rigorous clinical validation and ethical considerations in the development and deployment of digital health technologies to ensure their safe and effective integration into stroke care practices.

A saúde digital está transformando significativamente o cuidado com o acidente vascular cerebral (AVC), especialmente em regiões remotas e economicamente diversas, ao aproveitar tecnologias móveis e sem fio, big data e inteligência artificial (IA). Apesar dos avanços promissores, existe uma lacuna notável na validação clínica formal de muitas aplicações de saúde digital, levantando preocupações sobre sua eficácia e segurança em ambientes clínicos do mundo real. Nossa revisão explora sistematicamente a paisagem da saúde digital no cuidado do AVC, avaliando o desenvolvimento, validação e implementação de várias ferramentas digitais. Adotamos uma estratégia de busca abrangente, examinando artigos revisados por pares publicados entre janeiro de 2015 e janeiro de 2024, para reunir evidências sobre a eficácia das intervenções de saúde digital. Uma avaliação de qualidade rigorosa foi conduzida para garantir a confiabilidade dos estudos incluídos, com os achados sintetizados para destacar as principais inovações tecnológicas e seus resultados clínicos. Considerações éticas foram meticulosamente observadas para manter a confidencialidade e integridade dos dados. Nossas descobertas destacam o potencial transformador das tecnologias de saúde móvel, IA e telemedicina em melhorar a precisão diagnóstica, a eficácia do tratamento e os resultados dos pacientes no cuidado do AVC. Nosso artigo aprofunda-se na evolução e impacto da saúde digital na prevenção, diagnóstico, reabilitação e tratamento do AVC, enfatizando seu papel em melhorar o acesso ao cuidado especializado, mitigar atrasos no tratamento e melhorar os desfechos. No entanto, a revisão também sublinha a necessidade crítica de validação clínica rigorosa e considerações éticas no desenvolvimento e implantação de tecnologias de saúde digital para garantir sua integração segura e eficaz nas práticas de cuidado do AVC.

Technological Advances in the Diagnosis of Cardiovascular Disease: A Public Health Strategy.

This article reviews technological advances and global trends in the diagnosis, treatment, and monitoring of cardiovascular diseases. A bibliometric analysis was conducted using the SCOPUS database, following PRISMA-ScR guidelines, to identify relevant publications on technologies applied in the diagnosis and treatment of cardiovascular diseases. An increase in scientific output since 2018 was observed, reflecting a growing interest in the technologies available for the treatment of cardiovascular diseases, with terms such as "telemedicine", "artificial intelligence", "image analysis", and "cardiovascular disease" standing out as some of the most commonly used terms in reference to CVDs. Significant trends were identified, such as the use of artificial intelligence in precision medicine and machine learning algorithms to analyse data and predict cardiovascular risk, as well as advances in image analysis and 3D printing. Highlighting the role of artificial intelligence in the diagnosis and continuous monitoring of cardiovascular diseases, showing its potential to improve prognosis and reduce the incidence of acute cardiovascular events, this study presents the integration of traditional cardiology methods with digital health technologies-through a transdisciplinary approach-as a new direction in cardiovascular health, emphasising individualised care and improved clinical outcomes. These advances have great potential to impact healthcare, and as this field expands, it is crucial to understand the current research landscape and direction in order to take advantage of each technological advancement for improving the diagnosis, treatment, and quality of life of cardiovascular patients. It is concluded that the integration of these technologies into clinical practice has important implications for public health. Early detection and personalised treatment of cardiovascular diseases (CVDs) can significantly reduce the morbidity and mortality associated with these diseases. In addition, the optimisation of public health resources through telemedicine and telecare can improve access to quality care. The implementation of these technologies can be a crucial step towards reducing the global burden of cardiovascular diseases.