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

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Title: Clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis
Authors: Iqbal, F
Lam, K
Joshi, M
Khan, S
Ashrafian, H
Darzi, A
Item Type: Journal Article
Abstract: 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.
Issue Date: 8-Jan-2021
Date of Acceptance: 1-Dec-2020
URI: http://hdl.handle.net/10044/1/84928
DOI: 10.1038/s41746-020-00378-0
ISSN: 2398-6352
Publisher: Nature Research
Start Page: 1
End Page: 12
Journal / Book Title: npj Digital Medicine
Volume: 4
Copyright Statement: © The Author(s) 2021. 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/.
Publication Status: Published
Article Number: 7
Online Publication Date: 2021-01-08
Appears in Collections:Department of Surgery and Cancer
Faculty of Medicine
Institute of Global Health Innovation



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