Trends in telemedicine assessment indicate neglect of key criteria for predicting success.

PURPOSE: This innovative analysis aims to quantify the use of evaluation criteria in telemedicine and to identify current trends in metric adoption. The focus is to determine the frequency of actual performance metric reporting in telemedicine evaluation, in contrast to systematic reviews where assessment of study quality is the goal. DESIGN/METHODOLOGY/APPROACH: Automated literature search identified telemedicine studies reporting quantitative performance metrics. Studies were classified by telemedicine class; store-and-forward (SAF), real-time consultation (RTC) and telecare (TC), and study stage. Studies were scanned for evaluation metric reporting, i.e. clinical outcomes, satisfaction, patient quality and cost measures. FINDINGS: Evaluation metric use was compared among telemedicine classes, and between pilot and routine use stages. Diagnostic accuracy was reported significantly more frequently in pilots for RTC and TC. Cost measures were more frequently reported in routine use for TC. Clinical effectiveness and hospital attendance were better reported in routine use for SAF. Comparison also revealed different evaluation strategies. In pilots, SAF favoured diagnostic accuracy, compared to RTC and TC. TC preferred clinical effectiveness evaluations and TC more frequently assessed patient satisfaction. Cost was only reported in less than 20 per cent of studies, but most frequently in RTC. Routine use led to increased reporting of all metrics, except diagnostic accuracy. Clinical effectiveness reporting increased significantly with routine use for RTC and SAF, but declined for TC. ORIGINALITY/VALUE: Clinical outcomes and patient satisfaction were reported frequently in telemedicine studies, but reporting of other performance metrics was rare. Understanding current trends in metric reporting will facilitate better design of future telemedicine evaluations.

Sex allocation: size matters for red spider mites.

Many animals can adjust the sex ratio of their offspring according to their parental ability to invest. In spider mites, larger eggs are likely to be fertilized and produce diploid females, whereas smaller eggs produce haploid males.

Nutritional ecology: a first vegetarian spider.

Mutualisms are ubiquitous in nature and equally commonplace is their exploitation. A well-known mutualism has been found to be exploited from a surprising source: the first described vegetarian spider dines on trophic structures produced by acacia trees to reward their mutualistic protective ants.

Sympatric speciation: perfume preferences of orchid bee lineages.

Female attraction to an environmentally derived mating signal released by male orchid bees may be tightly linked to shared olfactory preferences of both sexes. A change in perfume preference may have led to divergence of two morphologically distinct lineages.

Interspecific communication: treehopper alarms make ants come running.

Stable mutualisms are ubiquitous in nature and this presents a puzzle for evolutionary biology. A new study of interactions between treehoppers and ants shows that honest communication coordinates anti-predator behaviour to improve the efficiency of the service ants provide.

Chemical coevolution: host-parasite arms race runs hot and cold.

Coevolution is a major process operating across biological communities at a range of spatial scales. Rapid ecological change makes it vital that we understand how coevolution proceeds if we are to conserve genetic diversity, combat disease and predict the effects of species invasions.

Social evolution: pathways to ant unicoloniality.

Unicolonial ant species live in interlinked populations known as super-colonies, where workers and queens move freely. New research suggests that low intra-specific resource competition leads to an absence of inter-colony aggression.

Kin recognition: knowing who's boss in wasp colonies.

Paper wasps recognise the dominant individual in their colony and surrender reproduction to this alpha individual. Contrary to expectations her dominance status is not signalled by a chemical indicator of fertility.

Insect communication: 'no entry' signal in ant foraging.

Forager ants lay attractive trail pheromones to guide nestmates to food, but the effectiveness of foraging networks might be improved if pheromones could also be used to repel foragers from unrewarding routes. Here we present empirical evidence for such a negative trail pheromone, deployed by Pharaoh's ants (Monomorium pharaonis) as a 'no entry' signal to mark an unrewarding foraging path. This finding constitutes another example of the sophisticated control mechanisms used in self-organized ant colonies.

Trail geometry gives polarity to ant foraging networks.

Pheromone trails are used by many ants to guide foragers between nest and food. But how does a forager that has become displaced from a trail know which way to go on rejoining the trail? A laden forager, for example, should walk towards the nest. Polarized trails would enable ants to choose the appropriate direction, thereby saving time and reducing predation risk. However, previous research has found no evidence that ants can detect polarity from the pheromone trail alone. Pharaoh's ants (Monomorium pharaonis) produce elaborate trail networks throughout their foraging environment. Here we show that by using information from the geometry of trail bifurcations within this network, foragers joining a trail can adaptively reorientate themselves if they initially walk in the wrong direction. The frequency of correct reorientations is maximized when the trail bifurcation angle is approximately 60 degrees, as found in natural networks. These are the first data to demonstrate how ant trails can themselves provide polarity information. They also demonstrate previously unsuspected sophistication in the organization and information content of networks in insect societies.