Telemedicine may cut emergency admissions for COPDBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d1499 (Published 07 March 2011) Cite this as: BMJ 2011;342:d1499
All rapid responses
The WSD has both scientific and political interest. Scientifically,
it is reassuring that (subject to the all-important step of academic peer
review) a large randomised controlled trial appears to have demonstrated
that in certain carefully selected individuals with particular conditions
and needs, remote monitoring and communication has had a statistically
significant impact on one or more predefined outcomes that are important
to patients. If true, this is progress indeed, and we should all find
time to read the detail and reflect on the implications.
Politically, it is less reassuring that the WSD trial and the various
qualitative evaluations which accompanied it have been so skilfully
appropriated by the Department of Health, who in my view never
demonstrated the level of equipoise about the outcomes which science
demands from a trial sponsor.
Why, for example, were positive quotes from satisfied participants
placed on the DOH website and used in briefing presentations before the
scientific papers offering a systematic analysis of the patient
perspective were allowed to be published? Why did the DOH website
describe it as a "common myth" that the introduction of telecare is going
to increase staff workload before the full case study analysis of the
organisational experience had been completed?
In short, the WSD appears to have answered the "can it work?"
question for some patients in some circumstances for some outcomes, but
the "does it work in practice?" and "is it worth it?" questions remain
Competing interests: No competing interests