TY - JOUR
T1 - Not all systematic reviews are systematic
T2 - A meta-review of the quality of systematic reviews for non-invasive remote monitoring in heart failure
AU - Conway, Aaron
AU - Inglis, Sally C.
AU - Chang, Anne M.
AU - Horton-Breshears, Margaret
AU - Cleland, John G.F.
AU - Clark, Robyn A.
N1 - Funding Information:
RAC is a Post-Doctoral Research Fellow supported by the NHMRC (grant no 570 141) and a Research SA Fellowship. SCI is supported by the NHMRC (grant bo 472699) and the Heart Foundation of Australia. JGFC has received funds from Philips and Bosch, which have a commercial interest in telemonitoring, and has acted as a paid advisor on the subject of this review.
PY - 2013
Y1 - 2013
N2 - We carried out a critical appraisal and synthesis of the systematic reviews and meta-analyses of remote monitoring for heart failure. A comprehensive literature search identified 65 relevant publications from 3333 citations. Seventeen studies fulfilled the inclusion and exclusion criteria. Seven (41%) systematic reviews pooled results for meta-analysis. Eight (47%) considered all non-invasive remote monitoring strategies. Five (29%) focused on telemonitoring. Four (24%) included both non-invasive and invasive technologies. The reviews were appraised by two independent reviewers for their quality and risk of bias using the AMSTAR tool. According to the AMSTAR criteria, ten (58%) systematic reviews were of poor methodological quality. In the high quality reviews, the relative risk of mortality in patients who received remote monitoring ranged from 0.53 to 0.88. The high quality reviews also reported that remote monitoring reduced the relative risk of all-cause (0.52 to 0.96) and heart failure-related hospitalizations (0.72 to 0.79) and, as a consequence, healthcare costs. However, further research is required before considering widespread implementation of remote monitoring. The subset of the heart failure population that derives the most benefit from intensive monitoring, the best technology, and the optimum duration of monitoring, all need to be identified.
AB - We carried out a critical appraisal and synthesis of the systematic reviews and meta-analyses of remote monitoring for heart failure. A comprehensive literature search identified 65 relevant publications from 3333 citations. Seventeen studies fulfilled the inclusion and exclusion criteria. Seven (41%) systematic reviews pooled results for meta-analysis. Eight (47%) considered all non-invasive remote monitoring strategies. Five (29%) focused on telemonitoring. Four (24%) included both non-invasive and invasive technologies. The reviews were appraised by two independent reviewers for their quality and risk of bias using the AMSTAR tool. According to the AMSTAR criteria, ten (58%) systematic reviews were of poor methodological quality. In the high quality reviews, the relative risk of mortality in patients who received remote monitoring ranged from 0.53 to 0.88. The high quality reviews also reported that remote monitoring reduced the relative risk of all-cause (0.52 to 0.96) and heart failure-related hospitalizations (0.72 to 0.79) and, as a consequence, healthcare costs. However, further research is required before considering widespread implementation of remote monitoring. The subset of the heart failure population that derives the most benefit from intensive monitoring, the best technology, and the optimum duration of monitoring, all need to be identified.
UR - http://www.scopus.com/inward/record.url?scp=84890174570&partnerID=8YFLogxK
U2 - 10.1177/1357633X13503427
DO - 10.1177/1357633X13503427
M3 - Review article
C2 - 24163297
AN - SCOPUS:84890174570
SN - 1357-633X
VL - 19
SP - 326
EP - 337
JO - Journal of Telemedicine and Telecare
JF - Journal of Telemedicine and Telecare
IS - 6
ER -