Banca de DEFESA: Helbert Eustáquio Cardoso da Silva

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : Helbert Eustáquio Cardoso da Silva
DATE: 08/12/2023
TIME: 09:00
LOCAL: Plataforma Teams
TITLE:

“Technology-mediated assistance: a possible approach in times of a pandemic?”

KEY WORDS:

“Covid-19, Teledentistry, Telemedicine, Telehealth, Monitoring, Oral Cancer, Head and Neck Cancer, Artificial Intelligence, Algorithm, Integrative Review, Systematic Review, Overview”

PAGES: 100
BIG AREA: Ciências da Saúde
AREA: Odontologia
SUMMARY:

“Introduction: The emergence of the new coronavirus (SARS-CoV-2) has resulted in a global public health crisis (COVID-19 pandemic), leading the World Health Organization (WHO) to declare it a public health emergency of international interest. In this pandemic context, it has become essential to ensure care for cancer patients, despite Lockdown and restrictions. Thus, Telemedicine proved to be a valuable tool in the evaluation and monitoring of the patient, as well as in the diagnosis of general or specific conditions. The non-face-to-face assistance, mediated by technology, was one of the alternatives found and was configured in a possible approach. But despite its potential benefits, what were its limitations? What could have been done differently? And in the field of dentistry: how was the assistance mediated by technology? Objectives: To evaluate the role of teledentistry in patients with oral cancer during the COVID-19 pandemic through an integrative review of the literature; to evaluate the feasibility of telehealth in the monitoring of patients with head and neck cancer through systematic review of remote technology, user adherence, user satisfaction and quality of life and to evaluate the use of artificial intelligence tools in cancer detection compared to traditional methods of diagnostic imaging through a panorama of systematic reviews. Methodology: Three literature reviews were carried out, being an integrative review, a systematic intervention review and a systematic diagnostic review to answer questions about the benefits, advantages and challenges of teledentistry during the COVID-19 pandemic19; the degree of user adherence, user satisfaction and quality of life in adopting telehealth for monitoring the treatment of patients with head and neck cancer; and how accurate are artificial intelligence applications for cancer detection in adult patients. The PICO (Population, Intervention, Comparison and Outcome) and PIRD (Participant, Index Test, Reference Test and Diagnosis of interest) strategy was used to define the inclusion and exclusion criteria in the reviews performed. Extensive research was conducted in databases such as PubMed, Cochrane Central Register of Controlled Studies (Cochrane), SciVerse Scopus (Scopus), Web of Science, Latin American and Caribbean Health Sciences (LILACS), Excerpta Medical Database (Embase)Scientific Electronic Library Online (Scielo), Business Source Complete (EBSCOhost) and in grey literature through PROQUEST, Google Scholar and JSTOR. Medical Subject Headings (MeSH) descriptors were used to develop the research strategy. The electronic search was standardized to identify relevant articles by combining all descriptors. Rayyan QCRI (https://rayyan.qcri.org/welcome) was used to remove duplicates, in addition to manual removal. The main primary outcomes considered were the benefits of the use of OT for patients undergoing treatment of mouth and head and neck cancer during the COVID-19 pandemic; application model already used in TM/Telehealth; number of patients who adhere to the use, quality of life and patient satisfaction in the use of the TM/Telehealth application and detection of cancer and diagnosis through artificial intelligence. The verification of methodological quality in individual studies was evaluated by the Critical Evaluation Checklist of the Joanna Briggs Institute (Instituto Joanna Briggs, 2014). This methodology was applied in systematic reviews. Results: In the first study, presented in chapter 2, it was observed that 78% of patients currently prefer teledentistry; 92% of patients would recommend the use of videoconsultation to other patients. The continuity of dental care, the reduction of visits of patients to the hospital, Reducing the risk of coronavirus infection and limiting face-to-face consultations to protect health professionals are benefits that reinforce the use of teledentistry by health institutions. In the second study, set out in chapter 3, although there was heterogeneity regarding the technology used, the included studies showed that remote monitoring and/or self-management of symptoms through mobile applications was feasible for most patients, with satisfactory degrees of acceptability, satisfaction, usability and adherence. In the third article, presented in chapter 4, it was demonstrated that several Artificial Intelligence approaches are promising in terms of specificity, sensitivity and diagnostic accuracy in the detection and diagnosis of malignant tumors.

Conclusion: From the articles, it was concluded that Technology-Mediated Assistance, during the COVID 19 pandemic, in the medical or dental fields, as a tool for remote monitoring of patients with oral cancer and head and neck cancer, was well accepted by patients, and contributed to the continuity of dental care, to reduce patient visits to the hospital, reducing the risk of coronavirus infection and limiting face-to-face care to protect health professionals. However, there was a need for a more userfriendly interface, an adequate evaluation of the user experience for a concrete applicability of these tools for monitoring patients with head and neck cancer. In this context, the detection and diagnosis of malignant tumors with the aid of AI seems to be feasible and accurate with the use of different technologies, deep learning and machine algorithms and radiomic analysis. The reviews indicate the benefits of technology-mediated care also for cancer patients, although these technologies are not able to replace the professional radiologist in the analysis of medical or dental images. Thus, although the evidence points out that technology-mediated care was a possible approach in times of pandemic, more longitudinal multicenter studies are needed for a better possibility of clinical application.”

COMMITTEE MEMBERS:
Externo à Instituição - CASSIUS CARVALHO TORRES-PEREIRA - UFPR
Interno - 3437282 - ANDRE FERREIRA LEITE
Externa à Instituição - MARIA ALVES GARCIA SANTOS SILVA - UFG
Interna - 1306536 - NAILE DAME TEIXEIRA
Presidente - 2315081 - NILCE SANTOS DE MELO