document: A systematic review of the efficacy of telemedicine for making diagnostic and management decisions We conducted a systematic review of the literature to evaluate the efficacy of telemedicine for making diagnostic and management decisions in three classes of application : office/hospital-based , store-and-forward , and home-based telemedicine . We searched the MEDLINE , EMBASE , CINAHL and HealthSTAR databases and printed resources , and interviewed investigators in the field . We excluded studies where the service did not historically require face-to-face encounters -LRB- e.g. radiology or pathology diagnosis -RRB- . A total of 58 articles met the inclusion criteria . The articles were summarized and graded for the quality and direction of the evidence . There were very few high-quality studies . The strongest evidence for the efficacy of telemedicine for diagnostic and management decisions came from the specialties of psychiatry and dermatology . There was also reasonable evidence that general medical history and physical examinations performed via telemedicine had relatively good sensitivity and specificity . Other specialties in which some evidence for efficacy existed were cardiology and certain areas of ophthalmology . Despite the widespread use of telemedicine in most major medical specialties , there is strong evidence in only a few of them that the diagnostic and management decisions provided by telemedicine are comparable to face-to-face care
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