Psychosocial Impact of Virtual Cancer Care through Technology: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Round 1

Reviewer 1 Report

This is a very relevant, well written systematic review on psychosocial outcomes of telemedicine in patients with cancer.

I only have a few remarks / questions:

1. why was your hypothesis one sided and not two sided? (deterioration of psychosocial health instead of 'deteriorates or improves'?

2. motivate why only RCTs were included

3.  I would like to see a discussion on the fact that included studies merely concerned women, while about half of persons affected by cancer are male. And would you expect other outcomes if more men had been included?

4. by excluding studies where in the intervention group patients was given the choice to have teleconsultations or live consultations, the study has become less patient centered. This might also be important to discuss

Author Response

Please see the attachment

Reviewer 2 Report

This is a review and (limited) meta analysis of the psychosocial impact of digital cancer care. 

In all the paper touches a relevant though not very spectacular topic; in different fields this has already been established as equivalent, but indeed not yet in oncology. The review seems to be performed according to methodological state of the art, though the selection of only 8 papers seems low.

This might have a relation with the scope and definition of the search terms.  Often this is called `digital` care, so using " virtual care replacing face to face hospital care" does not adequately define the field. I would advise to add digital care as objective and search term, not to speak of " decentralized" ( which is something totally different) and define the scope in " covering all aspects of follow up- and survivorship" or at least much more specific than now. 

If that leads to the same number of selected papers, so be it, but now I have some doubts.

So please use uniform definitions of virtual and/or digital care; please remove the wording "decentralized ..through technology" from the title and text, as this can also mean completely other developments.

Otherwise the paper is well written and presents a likely and relevant outcome. For reasons of accessibility and length, one could consider presenting the elaborate risk of bias descriptions in an appendix and just present a summary in the paper itself.

Author Response

Please see the attachment

Author Response File: Author Response.docx