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Evaluating the Validity and Utility of Wearable Technology for Continuously Monitoring Patients in a Hospital Setting: Systematic Review
BACKGROUND: The term posthospital syndrome has been used to describe the condition in which older patients are transiently frail after hospitalization and have a high chance of readmission. Since low activity and poor sleep during hospital stay may contribute to posthospital syndrome, the continuous...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411322/ https://www.ncbi.nlm.nih.gov/pubmed/34406121 http://dx.doi.org/10.2196/17411 |
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author | Patel, Vikas Orchanian-Cheff, Ani Wu, Robert |
author_facet | Patel, Vikas Orchanian-Cheff, Ani Wu, Robert |
author_sort | Patel, Vikas |
collection | PubMed |
description | BACKGROUND: The term posthospital syndrome has been used to describe the condition in which older patients are transiently frail after hospitalization and have a high chance of readmission. Since low activity and poor sleep during hospital stay may contribute to posthospital syndrome, the continuous monitoring of such parameters by using affordable wearables may help to reduce the prevalence of this syndrome. Although there have been systematic reviews of wearables for physical activity monitoring in hospital settings, there are limited data on the use of wearables for measuring other health variables in hospitalized patients. OBJECTIVE: This systematic review aimed to evaluate the validity and utility of wearable devices for monitoring hospitalized patients. METHODS: This review involved a comprehensive search of 7 databases and included articles that met the following criteria: inpatients must be aged >18 years, the wearable devices studied in the articles must be used to continuously monitor patients, and wearables should monitor biomarkers other than solely physical activity (ie, heart rate, respiratory rate, blood pressure, etc). Only English-language studies were included. From each study, we extracted basic demographic information along with the characteristics of the intervention. We assessed the risk of bias for studies that validated their wearable readings by using a modification of the Consensus-Based Standards for the Selection of Health Status Measurement Instruments. RESULTS: Of the 2012 articles that were screened, 14 studies met the selection criteria. All included articles were observational in design. In total, 9 different commercial wearables for various body locations were examined in this review. The devices collectively measured 7 different health parameters across all studies (heart rate, sleep duration, respiratory rate, oxygen saturation, skin temperature, blood pressure, and fall risk). Only 6 studies validated their results against a reference device or standard. There was a considerable risk of bias in these studies due to the low number of patients in most of the studies (4/6, 67%). Many studies that validated their results found that certain variables were inaccurate and had wide limits of agreement. Heart rate and sleep were the parameters with the most evidence for being valid for in-hospital monitoring. Overall, the mean patient completion rate across all 14 studies was >90%. CONCLUSIONS: The included studies suggested that wearable devices show promise for monitoring the heart rate and sleep of patients in hospitals. Many devices were not validated in inpatient settings, and the readings from most of the devices that were validated in such settings had wide limits of agreement when compared to gold standards. Even some medical-grade devices were found to perform poorly in inpatient settings. Further research is needed to determine the accuracy of hospitalized patients’ digital biomarker readings and eventually determine whether these wearable devices improve health outcomes. |
format | Online Article Text |
id | pubmed-8411322 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-84113222021-09-24 Evaluating the Validity and Utility of Wearable Technology for Continuously Monitoring Patients in a Hospital Setting: Systematic Review Patel, Vikas Orchanian-Cheff, Ani Wu, Robert JMIR Mhealth Uhealth Review BACKGROUND: The term posthospital syndrome has been used to describe the condition in which older patients are transiently frail after hospitalization and have a high chance of readmission. Since low activity and poor sleep during hospital stay may contribute to posthospital syndrome, the continuous monitoring of such parameters by using affordable wearables may help to reduce the prevalence of this syndrome. Although there have been systematic reviews of wearables for physical activity monitoring in hospital settings, there are limited data on the use of wearables for measuring other health variables in hospitalized patients. OBJECTIVE: This systematic review aimed to evaluate the validity and utility of wearable devices for monitoring hospitalized patients. METHODS: This review involved a comprehensive search of 7 databases and included articles that met the following criteria: inpatients must be aged >18 years, the wearable devices studied in the articles must be used to continuously monitor patients, and wearables should monitor biomarkers other than solely physical activity (ie, heart rate, respiratory rate, blood pressure, etc). Only English-language studies were included. From each study, we extracted basic demographic information along with the characteristics of the intervention. We assessed the risk of bias for studies that validated their wearable readings by using a modification of the Consensus-Based Standards for the Selection of Health Status Measurement Instruments. RESULTS: Of the 2012 articles that were screened, 14 studies met the selection criteria. All included articles were observational in design. In total, 9 different commercial wearables for various body locations were examined in this review. The devices collectively measured 7 different health parameters across all studies (heart rate, sleep duration, respiratory rate, oxygen saturation, skin temperature, blood pressure, and fall risk). Only 6 studies validated their results against a reference device or standard. There was a considerable risk of bias in these studies due to the low number of patients in most of the studies (4/6, 67%). Many studies that validated their results found that certain variables were inaccurate and had wide limits of agreement. Heart rate and sleep were the parameters with the most evidence for being valid for in-hospital monitoring. Overall, the mean patient completion rate across all 14 studies was >90%. CONCLUSIONS: The included studies suggested that wearable devices show promise for monitoring the heart rate and sleep of patients in hospitals. Many devices were not validated in inpatient settings, and the readings from most of the devices that were validated in such settings had wide limits of agreement when compared to gold standards. Even some medical-grade devices were found to perform poorly in inpatient settings. Further research is needed to determine the accuracy of hospitalized patients’ digital biomarker readings and eventually determine whether these wearable devices improve health outcomes. JMIR Publications 2021-08-18 /pmc/articles/PMC8411322/ /pubmed/34406121 http://dx.doi.org/10.2196/17411 Text en ©Vikas Patel, Ani Orchanian-Cheff, Robert Wu. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 18.08.2021. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on https://mhealth.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Review Patel, Vikas Orchanian-Cheff, Ani Wu, Robert Evaluating the Validity and Utility of Wearable Technology for Continuously Monitoring Patients in a Hospital Setting: Systematic Review |
title | Evaluating the Validity and Utility of Wearable Technology for Continuously Monitoring Patients in a Hospital Setting: Systematic Review |
title_full | Evaluating the Validity and Utility of Wearable Technology for Continuously Monitoring Patients in a Hospital Setting: Systematic Review |
title_fullStr | Evaluating the Validity and Utility of Wearable Technology for Continuously Monitoring Patients in a Hospital Setting: Systematic Review |
title_full_unstemmed | Evaluating the Validity and Utility of Wearable Technology for Continuously Monitoring Patients in a Hospital Setting: Systematic Review |
title_short | Evaluating the Validity and Utility of Wearable Technology for Continuously Monitoring Patients in a Hospital Setting: Systematic Review |
title_sort | evaluating the validity and utility of wearable technology for continuously monitoring patients in a hospital setting: systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411322/ https://www.ncbi.nlm.nih.gov/pubmed/34406121 http://dx.doi.org/10.2196/17411 |
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