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Clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis

Advances in digital technologies have allowed remote monitoring and digital alerting systems to gain popularity. Despite this, limited evidence exists to substantiate claims that digital alerting can improve clinical outcomes. The aim of this study was to appraise the evidence on the clinical outcom...

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Autores principales: Iqbal, Fahad M., Lam, Kyle, Joshi, Meera, Khan, Sadia, Ashrafian, Hutan, Darzi, Ara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794456/
https://www.ncbi.nlm.nih.gov/pubmed/33420338
http://dx.doi.org/10.1038/s41746-020-00378-0
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author Iqbal, Fahad M.
Lam, Kyle
Joshi, Meera
Khan, Sadia
Ashrafian, Hutan
Darzi, Ara
author_facet Iqbal, Fahad M.
Lam, Kyle
Joshi, Meera
Khan, Sadia
Ashrafian, Hutan
Darzi, Ara
author_sort Iqbal, Fahad M.
collection PubMed
description Advances in digital technologies have allowed remote monitoring and digital alerting systems to gain popularity. Despite this, limited evidence exists to substantiate claims that digital alerting can improve clinical outcomes. The aim of this study was to appraise the evidence on the clinical outcomes of digital alerting systems in remote monitoring through a systematic review and meta-analysis. A systematic literature search, with no language restrictions, was performed to identify studies evaluating healthcare outcomes of digital sensor alerting systems used in remote monitoring across all (medical and surgical) cohorts. The primary outcome was hospitalisation; secondary outcomes included hospital length of stay (LOS), mortality, emergency department and outpatient visits. Standard, pooled hazard ratio and proportion of means meta-analyses were performed. A total of 33 studies met the eligibility criteria; of which, 23 allowed for a meta-analysis. A 9.6% mean decrease in hospitalisation favouring digital alerting systems from a pooled random effects analysis was noted. However, pooled weighted mean differences and hazard ratios did not reproduce this finding. Digital alerting reduced hospital LOS by a mean difference of 1.043 days. A 3% mean decrease in all-cause mortality from digital alerting systems was noted. There was no benefit of digital alerting with respect to emergency department or outpatient visits. Digital alerts can considerably reduce hospitalisation and length of stay for certain cohorts in remote monitoring. Further research is required to confirm these findings and trial different alerting protocols to understand optimal alerting to guide future widespread implementation.
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spelling pubmed-77944562021-01-21 Clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis Iqbal, Fahad M. Lam, Kyle Joshi, Meera Khan, Sadia Ashrafian, Hutan Darzi, Ara NPJ Digit Med Review Article Advances in digital technologies have allowed remote monitoring and digital alerting systems to gain popularity. Despite this, limited evidence exists to substantiate claims that digital alerting can improve clinical outcomes. The aim of this study was to appraise the evidence on the clinical outcomes of digital alerting systems in remote monitoring through a systematic review and meta-analysis. A systematic literature search, with no language restrictions, was performed to identify studies evaluating healthcare outcomes of digital sensor alerting systems used in remote monitoring across all (medical and surgical) cohorts. The primary outcome was hospitalisation; secondary outcomes included hospital length of stay (LOS), mortality, emergency department and outpatient visits. Standard, pooled hazard ratio and proportion of means meta-analyses were performed. A total of 33 studies met the eligibility criteria; of which, 23 allowed for a meta-analysis. A 9.6% mean decrease in hospitalisation favouring digital alerting systems from a pooled random effects analysis was noted. However, pooled weighted mean differences and hazard ratios did not reproduce this finding. Digital alerting reduced hospital LOS by a mean difference of 1.043 days. A 3% mean decrease in all-cause mortality from digital alerting systems was noted. There was no benefit of digital alerting with respect to emergency department or outpatient visits. Digital alerts can considerably reduce hospitalisation and length of stay for certain cohorts in remote monitoring. Further research is required to confirm these findings and trial different alerting protocols to understand optimal alerting to guide future widespread implementation. Nature Publishing Group UK 2021-01-08 /pmc/articles/PMC7794456/ /pubmed/33420338 http://dx.doi.org/10.1038/s41746-020-00378-0 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Review Article
Iqbal, Fahad M.
Lam, Kyle
Joshi, Meera
Khan, Sadia
Ashrafian, Hutan
Darzi, Ara
Clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis
title Clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis
title_full Clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis
title_fullStr Clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis
title_full_unstemmed Clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis
title_short Clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis
title_sort clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794456/
https://www.ncbi.nlm.nih.gov/pubmed/33420338
http://dx.doi.org/10.1038/s41746-020-00378-0
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