Not all systematic reviews are systematic: A meta-review of the quality of systematic reviews for non-invasive remote monitoring in heart failure

Conway, A; Inglis, SC; Chang, AM; Horton-Breshears, M; Cleland, JGF; Clark, RA

Not all systematic reviews are systematic: A meta-review of the quality of systematic reviews for non-invasive remote monitoring in heart failure

Conway, A Inglis, SC

Chang, AM Horton-Breshears, M Cleland, JGF Clark, RA

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Publication Type:: Journal Article
Citation:: Journal of Telemedicine and Telecare, 2013, 19 (6), pp. 326 - 337
Issue Date:: 2013-12-17

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Field	Value	Language
dc.contributor.author	Conway, A	en_US
dc.contributor.author	Inglis, SC https://orcid.org/0000-0002-1331-5912	en_US
dc.contributor.author	Chang, AM	en_US
dc.contributor.author	Horton-Breshears, M	en_US
dc.contributor.author	Cleland, JGF	en_US
dc.contributor.author	Clark, RA	en_US
dc.date.issued	2013-12-17	en_US
dc.identifier.citation	Journal of Telemedicine and Telecare, 2013, 19 (6), pp. 326 - 337	en_US
dc.identifier.issn	1357-633X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/26752
dc.description.abstract	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. © The Author(s) 2013.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/GNT0472699
dc.relation.ispartof	Journal of Telemedicine and Telecare	en_US
dc.relation.isbasedon	10.1177/1357633X13503427	en_US
dc.subject.classification	Medical Informatics	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Monitoring, Physiologic	en_US
dc.subject.mesh	Telemedicine	en_US
dc.subject.mesh	Research Design	en_US
dc.subject.mesh	Heart Failure	en_US
dc.subject.mesh	Meta-Analysis as Topic	en_US
dc.subject.mesh	Systematic Reviews as Topic	en_US
dc.title	Not all systematic reviews are systematic: A meta-review of the quality of systematic reviews for non-invasive remote monitoring in heart failure	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	19	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	0806 Information Systems	en_US
utslib.for	0903 Biomedical Engineering	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access
pubs.issue	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	19	en_US

Abstract:

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. © The Author(s) 2013.

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http://hdl.handle.net/10453/26752