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

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 clinic...

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Autores principales:	Fahad M. Iqbal, Kyle Lam, Meera Joshi, Sadia Khan, Hutan Ashrafian, Ara Darzi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Computer applications to medicine. Medical informatics R858-859.7
Acceso en línea:	https://doaj.org/article/c8479eb676e04cf09d2b3cdef7608876
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spelling	oai:doaj.org-article:c8479eb676e04cf09d2b3cdef76088762021-12-02T16:05:59ZClinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis10.1038/s41746-020-00378-02398-6352https://doaj.org/article/c8479eb676e04cf09d2b3cdef76088762021-01-01T00:00:00Zhttps://doi.org/10.1038/s41746-020-00378-0https://doaj.org/toc/2398-6352Abstract 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.Fahad M. IqbalKyle LamMeera JoshiSadia KhanHutan AshrafianAra DarziNature PortfolioarticleComputer applications to medicine. Medical informaticsR858-859.7ENnpj Digital Medicine, Vol 4, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Computer applications to medicine. Medical informatics R858-859.7
spellingShingle	Computer applications to medicine. Medical informatics R858-859.7 Fahad M. Iqbal Kyle Lam Meera Joshi Sadia Khan Hutan Ashrafian Ara Darzi Clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis
description	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.
format	article
author	Fahad M. Iqbal Kyle Lam Meera Joshi Sadia Khan Hutan Ashrafian Ara Darzi
author_facet	Fahad M. Iqbal Kyle Lam Meera Joshi Sadia Khan Hutan Ashrafian Ara Darzi
author_sort	Fahad M. Iqbal
title	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_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_sort	clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/c8479eb676e04cf09d2b3cdef7608876
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Clinical outcomes of digital sensor alerting systems in remote monitoring: a systematic review and meta-analysis

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