Eligible articles by year of publication, country and journal type.

<p>Eligible articles by year of publication, country and journal type.</p

Flow chart of the literature search and screening process.

<p>Flow chart of the literature search and screening process.</p

Demographic information a) patient age in years, b) age in months in case of less than one year old patient c) patient weight, d) pre-existing conditions.

<p>Demographic information a) patient age in years, b) age in months in case of less than one year old patient c) patient weight, d) pre-existing conditions.</p

Entering a reference number to identify the injured person.

<p>Entering a reference number to identify the injured person.</p

When taking a photograph of the burn injury, the following tips are given to the user as part of the training process.

<p>When taking a photograph of the burn injury, the following tips are given to the user as part of the training process.</p

Image-Based Medical Expert Teleconsultation in Acute Care of Injuries. A Systematic Review of Effects on Information Accuracy, Diagnostic Validity, Clinical Outcome, and User Satisfaction

<div><p>Objective</p><p>To systematically review the literature on image-based telemedicine for medical expert consultation in acute care of injuries, considering system, user, and clinical aspects.</p><p>Design</p><p>Systematic review of peer-reviewed journal articles.</p><p>Data sources</p><p>Searches of five databases and in eligible articles, relevant reviews, and specialized peer-reviewed journals.</p><p>Eligibility criteria</p><p>Studies were included that covered teleconsultation systems based on image capture and transfer with the objective of seeking medical expertise for the diagnostic and treatment of acute injury care and that presented the evaluation of one or several aspects of the system based on empirical data. Studies of systems not under routine practice or including real-time interactive video conferencing were excluded.</p><p>Method</p><p>The procedures used in this review followed the PRISMA Statement. Predefined criteria were used for the assessment of the risk of bias. The DeLone and McLean Information System Success Model was used as a framework to synthesise the results according to system quality, user satisfaction, information quality and net benefits. All data extractions were done by at least two reviewers independently.</p><p>Results</p><p>Out of 331 articles, 24 were found eligible. Diagnostic validity and management outcomes were often studied; fewer studies focused on system quality and user satisfaction. Most systems were evaluated at a feasibility stage or during small-scale pilot testing. Although the results of the evaluations were generally positive, biases in the methodology of evaluation were concerning selection, performance and exclusion. Gold standards and statistical tests were not always used when assessing diagnostic validity and patient management.</p><p>Conclusions</p><p>Image-based telemedicine systems for injury emergency care tend to support valid diagnosis and influence patient management. The evidence relates to a few clinical fields, and has substantial methodological shortcomings. As in the case of telemedicine in general, user and system quality aspects are poorly documented, both of which affect scale up of such programs.</p></div

User Registration (a-b), selection of role (b), login (c) and list of cases according to status (d).

<p>User Registration (a-b), selection of role (b), login (c) and list of cases according to status (d).</p

Treatment advice provided by the burn expert.

<p>Treatment advice provided by the burn expert.</p

Web login and user interface for the burn expert.

<p>Web login and user interface for the burn expert.</p

The app in use.

<p>The app in use.</p