ACTFAST-3
Trial question
What is the role of intraoperative telemedicine program in surgical patients?
Study design
Single center
Open label
RCT
Population
Characteristics of study participants
51.0% female
49.0% male
N = 26254
26254 patients (13393 female, 12852 male)
Inclusion criteria: adult surgical patients
Key exclusion criteria: > 50% of the case duration outside of the Anesthesiology Control Tower staffed hours with exclusions for technological failures and personnel shortages
Interventions
N=12980 telemedicine support (anesthesia care monitored and augmented by decision support from a real time, live telemedicine intervention)
N=13274 usual care (usual anesthesia care)
Primary outcome
Avoidance of postoperative hypothermia
66.4
66.7
66.7 %
50.0 %
33.4 %
16.7 %
0.0 %
Telemedicine support
Usual care
No significant difference ↔
No significant difference in avoidance of postoperative hypothermia (66.4% vs. 66.7%; RR 1, 95% CI 0.97 to 1.02)
Secondary outcomes
No significant difference in avoidance of postoperative hyperglycemia (85.8% vs. 85.8%; RR 1, 95% CI 0.99 to 1.01)
Significant increase in intraoperative glucose measurement (68.7% vs. 63.8%; RR 1.07, 95% CI 1.01 to 1.15)
No significant difference in neuromuscular monitoring documentation (70.5% vs. 68.8%; RR 1.02, 95% CI 0.99 to 1.06)
Conclusion
In adult surgical patients, telemedicine support was not superior to usual care with respect to avoidance of postoperative hypothermia.
Reference
Christopher R King, Stephen Gregory, Bradley A Fritz et al. An Intraoperative Telemedicine Program to Improve Perioperative Quality Measures: The ACTFAST-3 Randomized Clinical Trial. JAMA Netw Open. 2023 Sep 5;6(9):e2332517.
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