title: An evaluation framework for defining the contributions of telestration in surgical telementoring.
abstract: BACKGROUND
  An increasing quantity of research in the domain of telemedicine show a growing popularity and acceptance of care over distance systems among both clinicians and patients. We focus on telementoring solutions, developed for providing remote guidance to less experienced surgeons. Telestration is often regarded as an extra functionality of some telementoring systems. However, we advocate that telestration must be viewed as a core feature of telementoring due to its advantages.
  
  
  OBJECTIVE
  To analyze and define concepts, parameters, and measurement procedures to evaluate the impact of using telestration while telementoring.
  
  
  METHODS
  A systematic review of research dealing with telestration during remote guidance sessions was performed by querying three major online research databases (MEDLINE, Association of Computing Machinery, and Institute of Electrical and Electronics Engineers) using a predefined set of keywords ("laparoscopy", "annotate", "telestrate", "telestration", "annotation", "minimally invasive", and "MIS").
  
  
  RESULTS
  The keyword-based search identified 117 papers. Following the guidelines for performing a systematic review, only 8 publications were considered relevant for the final study. Moreover, a gap in research defining the impacts of telestration during telementoring was identified. To fill this niche, a framework for analyzing, reporting, and measuring the impacts of telestration was proposed.
  
  
  CONCLUSIONS
  The presented framework lays the basics for the structured analysis and reporting of telestration applied to telementoring systems. It is the first step toward building an evidence knowledge base documenting the advantages of live video content annotation and supporting the presented connections between the concepts.
authors.affiliation: Faculty of Science and Technology, Department of Computer Science, University of Tromsø, Tromsø, Norway. andrius.budrionis@telemed.no.
authors.forename: Andrius
authors.initials: A
authors.lastname: Budrionis
authors.forename: Knut Magne
authors.initials: KM
authors.lastname: Augestad
authors.forename: Hiten Rh
authors.initials: HR
authors.lastname: Patel
authors.forename: Johan Gustav
authors.initials: JG
authors.lastname: Bellika
keywords: annotation; benefits; evaluation framework; impact; telementoring; telestration; theoretical models