Article(id=1241067197997568401, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202409415, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1727107200000, receivedDateStr=2024-09-24, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773823077916, onlineDateStr=2026-03-18, pubDate=1741536000000, pubDateStr=2025-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773823077916, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773823077916, creator=13701087609, updateTime=1773823077916, updator=13701087609, issue=Issue{id=1241067197318091153, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773823077754, creator=13701087609, updateTime=1773823268053, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241067995544482681, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241067995544482682, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=779, endPage=794, ext={EN=ArticleExt(id=1241067198274392469, articleId=1241067197997568401, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Bibliometric analysis of the application of telemedicine in cardiovascular disease management in low- and middle-income countries, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the research development trends of telemedicine applications in cardiovascular disease management in low- and middle-income countries based on bibliometric methods.

Methods

Research articles related to the application of telemedicine in cardiovascular disease management within middle-and low-income countries were retrieved from the Web of Science database, covering the period from January 1, 1998, to April 30, 2024. Using Excel, VOS viewer, and R software, we analyzed and visualized annual publication volume, regional research intensity, keywords, country citations, and conducted regional disparity and research topic analyses.

Results

A total of 514 articles were included in the study. The number of publications on telemedicine in cardiovascular disease management in low- and middle-income countries showed an upward trend from 1998 to 2023, particularly experiencing rapid growth since 2012. China (21%), the United States (13%), and India (11%) ranked as the top three countries in terms of research output. Among 134 low- and middle-income countries, 57(43%) reported the application of telemedicine in cardiovascular disease management, with the highest research output from China, India, Brazil, Iran, and Bangladesh. The research primarily focused on upper-middle-income (50.3%) and lower-middle-income countries (40.9%). The technological applications were concentrated in disease risk factor control, screening, and diagnosis, covering all stages of prevention. The most commonly used tools included mobile applications and wearable electrocardiogram devices, which have increasingly incorporated machine learning, deep learning, and artificial intelligence technologies in recent years. The target users of these technologies included the general public, patients, and healthcare service providers.

Conclusion

The volume of literature on telemedicine in cardiovascular disease management in low- and middle-income countries continues to grow, integrating into the entire management process of cardiovascular diseases in these regions.However, challenges such as the digital divide due to regional development disparities persist. There is an urgent need to promote the implementation of technology support and economic incentive policies, particularly in African countries, to establish an efficient, safe, and convenient digital cardiovascular disease management system.

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目的

基于文献计量,分析远程医疗在中低收入国家心血管疾病管理中应用的研究发展趋势。

方法

在Web of Science数据库中,检索1998年1月1日—2024年4月30日相关期刊刊载的远程医疗在中等收入国家和低收入国家的心血管疾病管理领域应用的研究。采用EXCEL、VOSviewer、R软件,分析并可视化年发文量、地区研究强度、关键词、国家引证等,并开展地域差异分析、研究主题分析。

结果

研究共纳入514篇文献,1998—2023年远程医疗在中低收入国家心血管疾病领域中的研究数量呈上升趋势,尤其从2012年开始快速增长,中国(21%)、美国(13%)、印度(11%)的研究数量位列前三。134个中低收入国家中,57(43%)个国家报道过远程医疗在心血管疾病管理的应用,中国、印度、巴西、伊朗、孟加拉国的研究文献居前五位;研究主要集中在中高收入国家(50.3%)和中低收入国家(40.9%)。技术应用场景聚焦于疾病风险因素控制、筛查、诊断等领域,涉及三级预防的各阶段;技术种类以手机为载体的APP和可穿戴心电图机为目前常用的工具,近年来逐步融入机器学习、深度学习、人工智能等技术;技术使用对象涉及大众、患者等医疗卫生服务需求方,以及医务人员等服务提供方。

结论

远程医疗在中低收入国家心血管疾病管理领域的文献数量持续增长,已融入中低收入国家的心血管疾病管理的全周期流程,但仍然存在地区发展不平等导致的数字鸿沟等问题,亟待在中低收入国家尤其是非洲地区国家推动技术支持、经济激励等政策落地,构建一个高效、安全且便捷的数字化心血管疾病管理体系。

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金音子,E-mail:
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黄可沛(2001—),男,硕士在读,研究方向:远程医疗、心血管疾病

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黄可沛(2001—),男,硕士在读,研究方向:远程医疗、心血管疾病

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NPJ Digit Med, 2023,6(1): 174., articleTitle=Implications for implementation and adoption of telehealth in developing countries: a systematic review of China's practices and experiences, refAbstract=null), Reference(id=1241067222152564991, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, doi=null, pmid=null, pmcid=null, year=2022, volume=13, issue=null, pageStart=2150, pageEnd=null, url=null, language=null, rfNumber=[32], rfOrder=31, authorNames=Zhang X, Mcjoynt T, Furst JW, journalName=Journal of Primary Care & Community Health, refType=null, unstructuredReference=Zhang X, Mcjoynt T, Furst JW, et al.Establishing a Patient-Centered virtual care model across the continuum of care[J]. Journal of Primary Care & Community Health, 2022, 13: 2150., articleTitle=Establishing a Patient-Centered virtual care model across the continuum of care, refAbstract=null)], funds=[Fund(id=1241067210844722057, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, awardId=72274005, language=CN, fundingSource=国家自然科学基金(72274005), fundOrder=null, country=null), Fund(id=1241067210953773971, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, awardId=9232009, language=CN, fundingSource=北京自然科学基金(9232009), fundOrder=null, country=null), Fund(id=1241067211092186020, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, awardId=20230484284, language=CN, fundingSource=北京市科技新星计划(20230484284), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241067203034927561, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, xref=1., ext=[AuthorCompanyExt(id=1241067203039121866, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, companyId=1241067203034927561, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Global Health, School of Public Health, Peking University, Beijing 100191, China), AuthorCompanyExt(id=1241067203047510475, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, companyId=1241067203034927561, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.北京大学公共卫生学院全球卫生学系,北京 100191)]), AuthorCompany(id=1241067203169145295, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, xref=2., ext=[AuthorCompanyExt(id=1241067203177533904, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, companyId=1241067203169145295, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.北京大学全球健康发展研究院,北京 100191)])], figs=[ArticleFig(id=1241067207568970412, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=EN, label=Figure 1, caption=Number of telemedicine studies related to cardiovascular disease management in low- and middle-income countries(1998—2024), figureFileSmall=zNqj0OQppOhpLbVBv7p3wQ==, figureFileBig=U3rpfoCCnSksrWaR/f4L4g==, tableContent=null), ArticleFig(id=1241067207703188151, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=CN, label=图1, caption=1998—2024年远程医疗在中低收入国家心血管疾病管理相关研究数量, figureFileSmall=zNqj0OQppOhpLbVBv7p3wQ==, figureFileBig=U3rpfoCCnSksrWaR/f4L4g==, tableContent=null), ArticleFig(id=1241067207975817947, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=EN, label=Figure 2, caption=Temporal trends in the number of telemedicine studies on cardiovascular disease management in low- and middle-income countries (1998—2024), figureFileSmall=ZTIrLzP7Nkc8z5wPjXJu4w==, figureFileBig=7PfqUfwQiYZbvwRrgLrbqA==, tableContent=null), ArticleFig(id=1241067208076481260, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=CN, label=图2, caption=1998—2024年间远程医疗在中低收入国家的心血管疾病管理的研究文献数量时间趋势, figureFileSmall=ZTIrLzP7Nkc8z5wPjXJu4w==, figureFileBig=7PfqUfwQiYZbvwRrgLrbqA==, tableContent=null), ArticleFig(id=1241067208185533175, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=EN, label=Figure 3, caption=Co-occurrence network of keywords in telemedicine studies on cardiovascular disease management in low- and middle-income countries (1998—2024) (Panel A: co-occurrence clustering network; Panel B: publication time overlay), figureFileSmall=3wf+2pBuQyNhH/2rJtpL2w==, figureFileBig=aXX8YLDXKblU32ghmzOdkg==, tableContent=null), ArticleFig(id=1241067208298779401, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=CN, label=图3, caption=1998—2024年远程医疗在中低收入国家心血管疾病管理相关研究关键词共现网络

注:图A共现聚类网络;图B发表时间叠加。

, figureFileSmall=3wf+2pBuQyNhH/2rJtpL2w==, figureFileBig=aXX8YLDXKblU32ghmzOdkg==, tableContent=null), ArticleFig(id=1241067208432997144, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=EN, label=Table 1, caption=

Expansion of literature search keywords

, figureFileSmall=null, figureFileBig=null, tableContent=
主题关键词同义词
Telehealth“telemedicine” OR“digital health” OR“digital medicine” OR“mobile health” OR “electronic health” OR“ehealth” OR “mhealth” OR “teleconsultation” OR“remote consultation” OR“remote monitoring” OR“remote rehabilitation” OR“wearable device” OR “telephone” OR “mobile phone” OR“artificial intelligence” OR“information technology”
Cardiovascular disease“CVD” OR“myocardial infarction” OR“MI” OR“cardiac rehabilitation” OR “coronary” OR“Acute Coronary Syndrome” OR“ACS” OR “Arrhythmia” OR cardio* OR cardiac* OR heart*
LMICs“developing countries” OR“less developed countries” OR“third-world countries” OR “under-developed countries” OR“poor countries” OR “less developed countries” OR“under developed countries” OR“less developed nations” OR“third world nations” OR “under developed nations” OR “developing nations” OR“poor nations” OR“poor economies” OR“third world economies” OR“developing economies” OR“under developed economies” OR“less developed economies”
), ArticleFig(id=1241067208525271843, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=CN, label=表1, caption=

文献检索关键词同义扩展

, figureFileSmall=null, figureFileBig=null, tableContent=
主题关键词同义词
Telehealth“telemedicine” OR“digital health” OR“digital medicine” OR“mobile health” OR “electronic health” OR“ehealth” OR “mhealth” OR “teleconsultation” OR“remote consultation” OR“remote monitoring” OR“remote rehabilitation” OR“wearable device” OR “telephone” OR “mobile phone” OR“artificial intelligence” OR“information technology”
Cardiovascular disease“CVD” OR“myocardial infarction” OR“MI” OR“cardiac rehabilitation” OR “coronary” OR“Acute Coronary Syndrome” OR“ACS” OR “Arrhythmia” OR cardio* OR cardiac* OR heart*
LMICs“developing countries” OR“less developed countries” OR“third-world countries” OR “under-developed countries” OR“poor countries” OR “less developed countries” OR“under developed countries” OR“less developed nations” OR“third world nations” OR “under developed nations” OR “developing nations” OR“poor nations” OR“poor economies” OR“third world economies” OR“developing economies” OR“under developed economies” OR“less developed economies”
), ArticleFig(id=1241067208638518068, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=EN, label=Table 2, caption=

Research hotspots of telemedicine in cardiovascular disease management in low- and middle-income countries(1998—2024)

, figureFileSmall=null, figureFileBig=null, tableContent=
项目文章数/引用数
(%)
最高产作者
RIBEIRO ALP17 (3.3)
MARCOLINO MS13 (2.5)
PRABHAKARAN D12 (2.3)
TANDON N12 (2.3)
RIBEIRO AL11 (2.1)
最高被引文章*
GUO YT, 2019, J AM COLL CARDIOL241 (1.8)
RAMACHANDRAN A, 2013, LANCET DIABETES214 (1.6)
ENDO
GUO YT, 2020, J AM COLL CARDIOL186 (1.4)
DOVAL HC, 2005, BMJ-BRIT MED J137 (1.0)
JARAB AS, 2012, J MANAGE CARE PHARM124 (0.9)
最多通讯作者所在国
CHINA106 (21)
USA66 (13)
INDIA57 (11)
BRAZIL51 (10)
IRAN17 (3)
最多文章所在期刊
JMIR MHEALTH AND UHEALTH18 (3.6)
BMJ OPEN16 (3.1)
TELEMEDICINE AND E-HEALTH16 (3.1)
TRIALS14 (2.7)
JOURNAL OF MEDICAL INTERNET RESEARCH13 (2.5)
), ArticleFig(id=1241067208718209855, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=CN, label=表2, caption=

1998—2024年远程医疗在中低收入国家心血管疾病管理相关研究热点

, figureFileSmall=null, figureFileBig=null, tableContent=
项目文章数/引用数
(%)
最高产作者
RIBEIRO ALP17 (3.3)
MARCOLINO MS13 (2.5)
PRABHAKARAN D12 (2.3)
TANDON N12 (2.3)
RIBEIRO AL11 (2.1)
最高被引文章*
GUO YT, 2019, J AM COLL CARDIOL241 (1.8)
RAMACHANDRAN A, 2013, LANCET DIABETES214 (1.6)
ENDO
GUO YT, 2020, J AM COLL CARDIOL186 (1.4)
DOVAL HC, 2005, BMJ-BRIT MED J137 (1.0)
JARAB AS, 2012, J MANAGE CARE PHARM124 (0.9)
最多通讯作者所在国
CHINA106 (21)
USA66 (13)
INDIA57 (11)
BRAZIL51 (10)
IRAN17 (3)
最多文章所在期刊
JMIR MHEALTH AND UHEALTH18 (3.6)
BMJ OPEN16 (3.1)
TELEMEDICINE AND E-HEALTH16 (3.1)
TRIALS14 (2.7)
JOURNAL OF MEDICAL INTERNET RESEARCH13 (2.5)
), ArticleFig(id=1241067208873399113, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=EN, label=Table 3, caption=

Number of articles on telemedicine in cardiovascular disease management in low- and middle-income countries by country (1998—2024)

, figureFileSmall=null, figureFileBig=null, tableContent=
研究所在国文章数研究所在国文章数
中国113不丹2
印度71佛得角2
巴西58海地2
伊朗20哈萨克斯坦2
孟加拉国18秘鲁2
印尼17斯里兰卡2
马来西亚16坦桑尼亚2
巴基斯坦12刚果民主共和国2
哥伦比亚12突尼斯2
肯尼亚11安哥拉1
南非11阿塞拜疆1
阿根廷10保加利亚1
泰国10喀麦隆1
约旦10古巴1
土耳其8多米尼加1
乌干达8埃及1
加纳7埃塞俄比亚1
墨西哥6洪都拉斯1
尼泊尔6象牙海岸1
越南6马拉维1
柬埔寨5马里1
尼日利亚5巴拉圭1
俄罗斯4塞内加尔1
菲律宾4塞尔维亚1
格鲁吉亚4所罗门群岛1
玻利维亚3索马里1
厄瓜多尔3苏里南1
黎巴嫩3阿拉伯叙利亚共和国1
危地马拉3
), ArticleFig(id=1241067208982451029, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=CN, label=表3, caption=

1998—2024年远程医疗在中低收入国家心血管疾病管理相关研究所在国文章数量

, figureFileSmall=null, figureFileBig=null, tableContent=
研究所在国文章数研究所在国文章数
中国113不丹2
印度71佛得角2
巴西58海地2
伊朗20哈萨克斯坦2
孟加拉国18秘鲁2
印尼17斯里兰卡2
马来西亚16坦桑尼亚2
巴基斯坦12刚果民主共和国2
哥伦比亚12突尼斯2
肯尼亚11安哥拉1
南非11阿塞拜疆1
阿根廷10保加利亚1
泰国10喀麦隆1
约旦10古巴1
土耳其8多米尼加1
乌干达8埃及1
加纳7埃塞俄比亚1
墨西哥6洪都拉斯1
尼泊尔6象牙海岸1
越南6马拉维1
柬埔寨5马里1
尼日利亚5巴拉圭1
俄罗斯4塞内加尔1
菲律宾4塞尔维亚1
格鲁吉亚4所罗门群岛1
玻利维亚3索马里1
厄瓜多尔3苏里南1
黎巴嫩3阿拉伯叙利亚共和国1
危地马拉3
), ArticleFig(id=1241067209116668777, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=EN, label=Table 4, caption=

Keyword frequency in articles on telemedicine for cardiovascular disease management in low- and middle-income countries (1998—2024)

, figureFileSmall=null, figureFileBig=null, tableContent=
关键词频次关键词频次
telehealth151outcomes34
mhealth94primary care31
CVD88telephone30
hypertension78adherence28
management76mortality27
information technology68medication adherence25
intervention60myocardial infarction25
care52nursing25
ECG47adults23
blood pressure42healthcare23
prevention42stroke23
diabetes40cardiac rehabilitation22
prevalence37heart failure22
self-management37china21
risk35risk factor20
), ArticleFig(id=1241067210647589751, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067197997568401, language=CN, label=表4, caption=

1998—2024年远程医疗在中低收入国家心血管疾病管理相关文章关键词词频

, figureFileSmall=null, figureFileBig=null, tableContent=
关键词频次关键词频次
telehealth151outcomes34
mhealth94primary care31
CVD88telephone30
hypertension78adherence28
management76mortality27
information technology68medication adherence25
intervention60myocardial infarction25
care52nursing25
ECG47adults23
blood pressure42healthcare23
prevention42stroke23
diabetes40cardiac rehabilitation22
prevalence37heart failure22
self-management37china21
risk35risk factor20
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远程医疗在中低收入国家心血管疾病管理中应用的文献计量分析
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黄可沛 1 , 王敏敏 1 , 李斯雯 1 , 冯羿凯 1 , 金音子 1, 2 , 郑志杰 1, 2
现代预防医学 | 流行病与统计方法 2025,52(5): 779-794
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现代预防医学 | 流行病与统计方法 2025, 52(5): 779-794
远程医疗在中低收入国家心血管疾病管理中应用的文献计量分析
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黄可沛1, 王敏敏1, 李斯雯1, 冯羿凯1, 金音子1, 2 , 郑志杰1, 2
作者信息
  • 1.北京大学公共卫生学院全球卫生学系,北京 100191
  • 2.北京大学全球健康发展研究院,北京 100191
  • 黄可沛(2001—),男,硕士在读,研究方向:远程医疗、心血管疾病

通讯作者:

金音子,E-mail:
Bibliometric analysis of the application of telemedicine in cardiovascular disease management in low- and middle-income countries
Ke-pei HUANG1, Min-min WANG1, Si-wen LI1, Yi-kai FENG1, Yin-zi JIN1, 2 , Zhi-jie ZHENG1, 2
Affiliations
  • Department of Global Health, School of Public Health, Peking University, Beijing 100191, China
出版时间: 2025-03-10 doi: 10.20043/j.cnki.MPM.202409415
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目的

基于文献计量,分析远程医疗在中低收入国家心血管疾病管理中应用的研究发展趋势。

方法

在Web of Science数据库中,检索1998年1月1日—2024年4月30日相关期刊刊载的远程医疗在中等收入国家和低收入国家的心血管疾病管理领域应用的研究。采用EXCEL、VOSviewer、R软件,分析并可视化年发文量、地区研究强度、关键词、国家引证等,并开展地域差异分析、研究主题分析。

结果

研究共纳入514篇文献,1998—2023年远程医疗在中低收入国家心血管疾病领域中的研究数量呈上升趋势,尤其从2012年开始快速增长,中国(21%)、美国(13%)、印度(11%)的研究数量位列前三。134个中低收入国家中,57(43%)个国家报道过远程医疗在心血管疾病管理的应用,中国、印度、巴西、伊朗、孟加拉国的研究文献居前五位;研究主要集中在中高收入国家(50.3%)和中低收入国家(40.9%)。技术应用场景聚焦于疾病风险因素控制、筛查、诊断等领域,涉及三级预防的各阶段;技术种类以手机为载体的APP和可穿戴心电图机为目前常用的工具,近年来逐步融入机器学习、深度学习、人工智能等技术;技术使用对象涉及大众、患者等医疗卫生服务需求方,以及医务人员等服务提供方。

结论

远程医疗在中低收入国家心血管疾病管理领域的文献数量持续增长,已融入中低收入国家的心血管疾病管理的全周期流程,但仍然存在地区发展不平等导致的数字鸿沟等问题,亟待在中低收入国家尤其是非洲地区国家推动技术支持、经济激励等政策落地,构建一个高效、安全且便捷的数字化心血管疾病管理体系。

心血管疾病  /  远程医疗  /  中低收入国家  /  文献计量学
Objective

To analyze the research development trends of telemedicine applications in cardiovascular disease management in low- and middle-income countries based on bibliometric methods.

Methods

Research articles related to the application of telemedicine in cardiovascular disease management within middle-and low-income countries were retrieved from the Web of Science database, covering the period from January 1, 1998, to April 30, 2024. Using Excel, VOS viewer, and R software, we analyzed and visualized annual publication volume, regional research intensity, keywords, country citations, and conducted regional disparity and research topic analyses.

Results

A total of 514 articles were included in the study. The number of publications on telemedicine in cardiovascular disease management in low- and middle-income countries showed an upward trend from 1998 to 2023, particularly experiencing rapid growth since 2012. China (21%), the United States (13%), and India (11%) ranked as the top three countries in terms of research output. Among 134 low- and middle-income countries, 57(43%) reported the application of telemedicine in cardiovascular disease management, with the highest research output from China, India, Brazil, Iran, and Bangladesh. The research primarily focused on upper-middle-income (50.3%) and lower-middle-income countries (40.9%). The technological applications were concentrated in disease risk factor control, screening, and diagnosis, covering all stages of prevention. The most commonly used tools included mobile applications and wearable electrocardiogram devices, which have increasingly incorporated machine learning, deep learning, and artificial intelligence technologies in recent years. The target users of these technologies included the general public, patients, and healthcare service providers.

Conclusion

The volume of literature on telemedicine in cardiovascular disease management in low- and middle-income countries continues to grow, integrating into the entire management process of cardiovascular diseases in these regions.However, challenges such as the digital divide due to regional development disparities persist. There is an urgent need to promote the implementation of technology support and economic incentive policies, particularly in African countries, to establish an efficient, safe, and convenient digital cardiovascular disease management system.

Cardiovascular disease  /  Telemedicine  /  Low- and middle-income countries  /  Bibliometrics
黄可沛, 王敏敏, 李斯雯, 冯羿凯, 金音子, 郑志杰. 远程医疗在中低收入国家心血管疾病管理中应用的文献计量分析. 现代预防医学, 2025 , 52 (5) : 779 -794 . DOI: 10.20043/j.cnki.MPM.202409415
Ke-pei HUANG, Min-min WANG, Si-wen LI, Yi-kai FENG, Yin-zi JIN, Zhi-jie ZHENG. Bibliometric analysis of the application of telemedicine in cardiovascular disease management in low- and middle-income countries[J]. Modern Preventive Medicine, 2025 , 52 (5) : 779 -794 . DOI: 10.20043/j.cnki.MPM.202409415
中低收入国家心血管疾病负担持续数十年的上升趋势,与高收入国家(high income countries,HICs)相比,估计>80%的心血管疾病患者生活在中低收入国家,并有超过四分之三的心血管疾病死亡发生在这些国家[1]。远程医疗(telehealth)技术作为数字健康干预措施中的重要组成部分,通过利用互联网、移动通信、可穿戴设备等信息技术可以克服地域限制,为中低收入国家的患者提供更便利、高效、及时、低成本的医疗服务,并增强患者的就诊参与感和自我管理能力,改善医疗效果[2-4],为中低收入国家心血管疾病管理带来了新的机遇。然而,远程医疗在中低收入国家的发展与推广仍然存在一些障碍,分别在政策、技术、个人、组织四大方面存在不足[5],主要体现在干预措施的成本效益[6-7]、非劣性[8-11]、可接受性[12-13]等方面。本文基于Web of Science核心合集的文献计量分析,系统梳理远程医疗在中低收入国家心血管疾病管理相关研究的发展趋势,分析技术应用的研究热点、地域差异、技术分类,以弥补由于缺乏循证证据导致技术应用不佳所造成的数字鸿沟。
本研究以“远程医疗”“心血管疾病”“中低收入国家”作为主题关键词,对Web of Science核心合集进行文献检索,检索式为:TS=“(telehealth”OR“ Cardiovascular disease”) AND ALL=“(LMICs”),检索时对每个主题关键词进行同义词扩展,检索时间截至2024年4月30日,见表1
纳入标准:(1)研究远程医疗技术(包括但不限于可穿戴设备、智能手机、APP等)的实际使用;(2)研究人群处于中低收入国家,并具有心血管疾病及其高危因素(高血压、高血糖等)。排除标准:(1)文章内容与心血管疾病及其高危因素(肥胖、高血压、糖尿病等)无关;(2)研究类型为综述、文献计量、新闻类别等或无法获取全文。
本研究使用Endnote软件整合纳入文献,首先通过全面审阅每篇文献,记录并统计研究时间与研究对象国籍,使用EXCEL软件可视化研究文章数量时间发展趋势,使用R软件分析并可视化各国的研究关注度与差异度;随后使用VOSviewer软件筛选并归类关键词,进行词频统计与聚类分析,以识别研究热点及关键词间潜在联系。
共在Web of Science核心合集检索到1 479篇文献。通过对文献标题与摘要的筛选,排除不符合标准的文献,最终纳入514篇文献进行分析。
本研究纳入的514篇文献的发表时间分布在1998—2024年。总体而言,远程医疗在中低收入国家的心血管疾病管理中的相关研究年度发文量总体呈上升趋势,在1998—2011年间文献数量较少,2012年文献数量开始快速增长,提示该领域受到了研究者越来越高的重视。见图1
1998—2024年,相关主题研究中最高产作者前五位是RIBEIRO ALP(巴西,17篇)、MARCOLINO MS(巴西,13篇)、PRABHAKARAN D(印度,12篇)、TANDON N(印度,12篇)、RIBEIRO AL(巴西,11篇)。最多通信作者所在国分别是中国(106篇)、美国(66篇)、印度(57篇)、巴西(51篇)、伊朗(17篇)。最多文章所在期刊前五位是JMIR MHEALTH AND UHEALTH(18篇)、BMJ OPEN(16篇)、TELEMEDICINE AND E-HEALTH(16篇)、TRIALS(14篇)、JOURNAL OF MEDICAL INTERNET RESEARCH(13篇)。最高被引文章前五位是中国人民解放军总医院的郭豫涛教授团队的两篇文章,被引次数分居第一、第三,印度的Ambady Ramachandran团队、阿根廷的DOVAL HC团队、约旦的Anan Sadeq Jarab团队的文章,被引次数分居第二、四、五位。见表2
134个中低收入国家(含战乱地区)中,有57个(43%)国家在1998—2024年有远程医疗在心血管疾病中的应用情况报道,其中,中国、印度、巴西、伊朗、孟加拉国的文献数量居前五,见表3。其中,研究较多的国家多集中在金砖国家,在非洲、中东非地区的中低收入国家的相关研究少,侧面说明了这些地区的远程医疗技术的发展水平(尤其是在心血管疾病方面)较低。
区域差异上,研究低收入国家的文献共13篇(2.8%),中低收入国家190篇(40.9%),中高收入国家261篇(50.3%)。时间趋势上,低收入国家的文献量在近几年略有提升但速度十分缓慢;中低、中高收入国家的文献量自2012年开始快速增长,中高收入国家的文献量自2015年开始明显高于中低收入国家,2019年左右所有类型的文献数均达到峰值,见图2
本研究使用VOSviewer软件对纳入文献的所有关键词(author keywords,keywords-plus)进行关键词共现网络分析,分析时进行同义词合并与格式统一,记录出现频次前30个关键词及其频次,其中,出现频次前十名的依次为:telehealth 151次、mhealth 94次、cardiovascular disease 88次、hypertension 78次、management 76次、information technology 68次、intervention 60次、care 52次、ECG 47次、blood pressure 42次。见表4
对关键词进行聚类分析发现,主要可以分为三大类:疾病风险因素、技术种类与形式、管理方式与阶段。疾病风险因素有“高血压”“糖尿病”“肥胖”“超重”等;技术种类与形式有“心电图”“人工智能”“物联网”“电子健康记录”“APP或手机”等;管理方式与阶段有“生活方式干预”“自我管理”“护理”“急救”“诊断”“筛查”等。提示通过远程医疗干预控制心血管疾病的危险因素是心血管疾病管理一条重要的途径,管理涉及三级预防全过程,以手机为载体的APP和心电图是目前常用的干预工具。近几年兴起的研究关键词有“人工智能”“手机APP”“接受度”“数字健康”“应用”“深度学习”“筛查”,提示了该领域目前的新兴方向。见图3
本研究发现,1998—2023年远程医疗在中低收入国家心血管疾病管理领域的文献数量持续增长,反映出这些国家研究能力的提升。这一现象反映出信息技术的进步,使得智能手机、可穿戴设备等远程医疗工具逐渐普及[14];同时,各国政府通过政策支持和国际合作,推动了远程医疗基础设施的建设和发展[15]。此外,心血管疾病负担加重以及公众健康意识的提高,进一步激发了对远程医疗的需求[16]
地域差异分析表明,中低收入国家在心血管疾病管理领域的远程医疗研究呈现不均衡态势,中高收入国家的文献数量及增速远超中低、低收入国家,例如非洲地区的研究较少,提示远程医疗虽能提高医疗卫生服务的可及性、有效缓解医疗资源短缺[17],但数字鸿沟仍在显著加剧[18]。依据技术接受与使用统一理论[19],远程医疗技术的推广及应用受到多方面因素的影响,包括服务提供方的绩效期望、自我效能、技术使用的激励措施,以及服务需求方的健康素养、对技术的信任度等[20-26]。因此,相关政府部门及医疗卫生机构应采取相应措施,包括但不限于为医务人员提供必要的技术支持及制定激励机制,对患者进行健康宣教等,以促进远程医疗技术在心血管疾病管理领域的应用及推广。
研究主题分析发现,远程医疗已融入中低收入国家的心血管疾病管理的全周期流程,涉及从高危因素预防到疾病筛查、诊断、预后管理的各个环节,具有广泛的应用前景。远程医疗平台的搭建促进了区域协同救治流程的优化,增加了患者对医疗卫生资源的可及性[27-28],然而远程医疗平台在应用过程中,仍存在一些不足,如技术基础设施薄弱及数据隐私安全等[20,29-30],这提示远程医疗平台的搭建不仅需要技术支撑,还需要相关的政策配套措施,政策制定者、技术开发部门及相关利益方应加强协同合作[31],以推动远程医疗的可持续发展,构建一个高效、安全且便捷的数字化心血管疾病管理体系[32]
尽管远程医疗在心血管疾病管理中展现出了显著的潜力,其广泛应用仍面临诸多挑战,尤其是地区发展不平等导致的数字鸿沟等问题亟需有效的解决方案。未来的研究与实践应当专注于缩小数字鸿沟,确保不同地区和人群能平等地受益于远程医疗服务的发展与进步。
  • 国家自然科学基金(72274005)
  • 北京自然科学基金(9232009)
  • 北京市科技新星计划(20230484284)
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2025年第52卷第5期
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doi: 10.20043/j.cnki.MPM.202409415
  • 接收时间:2024-09-24
  • 首发时间:2026-03-18
  • 出版时间:2025-03-10
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  • 收稿日期:2024-09-24
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国家自然科学基金(72274005)
北京自然科学基金(9232009)
北京市科技新星计划(20230484284)
作者信息
    1.北京大学公共卫生学院全球卫生学系,北京 100191
    2.北京大学全球健康发展研究院,北京 100191

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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