Telemonitoramento por aplicativo de celular como estratégia de assistência odontológica para crianças e adolescentes com câncer

Abstract

The use of mobile applications as a telemonitoring tool can be considered an applicable strategy in Dentistry for the prevention, promotion of oral health, and assistance in the diagnosis of comorbidities. From the perspective of pediatric cancer patients, comprehensive dental care is needed in conjunction with the care provided by the multidisciplinary team. Thus, the objective of this dissertation is to evaluate the photographic tool of a mobile application to enable subsequent telemonitoring of dental conditions in children and adolescents with cancer. For this purpose, two work plans were developed. In the first plan, information on the accuracy of photos taken with mobile applications for the detection of potentially malignant lesions and the monitoring of patients was evaluated through a systematic review with meta-analysis. Its results suggest the feasibility of diagnosis through remote exams with photos taken by applications and indicate the possibility of using these technologies in regions where access to healthcare professionals is not guaranteed. The importance of further research on this topic is also emphasized to ensure the effective incorporation of similar remote exams in dental clinical practice. In the second plan, the accuracy of remote examination of oral mucositis through photos taken by the Pediatric Oncology Telemonitoring (TON) mobile application was assessed. This plan sought to evaluate the scientifically based remote telemonitoring strategy discussed in the first plan. The development of TON can be considered one of the major advances in dental care provided to pediatric patients in the studied oncology hospital, and this application seems to be a viable option to expand attention both in the hospital environment and remotely, in the cities where children, adolescents, and their families reside. The sensitivity, specificity, and accuracy results of TON application for remote examination of oral mucositis and severe oral mucositis were favorable. Initial cases of oral mucositis could be identified through photographs, suggesting that patients with this condition can be remotely guided if this tool is made available for use.