scholarly journals Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Jobbe PL Leenen ◽  
Crista Leerentveld ◽  
Joris D van Dijk ◽  
Henderik L van Westreenen ◽  
Lisette Schoonhoven ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Clinical Outcomes ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Wireless Devices

BACKGROUND Continuous monitoring of vital signs by using wearable wireless devices may allow for timely detection of clinical deterioration in patients in general wards in comparison to detection by standard intermittent vital signs measurements. A large number of studies on many different wearable devices have been reported in recent years, but a systematic review is not yet available to date. OBJECTIVE The aim of this study was to provide a systematic review for health care professionals regarding the current evidence about the validation, feasibility, clinical outcomes, and costs of wearable wireless devices for continuous monitoring of vital signs. METHODS A systematic and comprehensive search was performed using PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 2009 to September 2019 for studies that evaluated wearable wireless devices for continuous monitoring of vital signs in adults. Outcomes were structured by validation, feasibility, clinical outcomes, and costs. Risk of bias was determined by using the Mixed Methods Appraisal Tool, quality assessment of diagnostic accuracy studies 2nd edition, or quality of health economic studies tool. RESULTS In this review, 27 studies evaluating 13 different wearable wireless devices were included. These studies predominantly evaluated the validation or the feasibility outcomes of these devices. Only a few studies reported the clinical outcomes with these devices and they did not report a significantly better clinical outcome than the standard tools used for measuring vital signs. Cost outcomes were not reported in any study. The quality of the included studies was predominantly rated as low or moderate. CONCLUSIONS Wearable wireless continuous monitoring devices are mostly still in the clinical validation and feasibility testing phases. To date, there are no high quality large well-controlled studies of wearable wireless devices available that show a significant clinical benefit or cost-effectiveness. Such studies are needed to help health care professionals and administrators in their decision making regarding implementation of these devices on a large scale in clinical practice or in-home monitoring.

scholarly journals Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

10.2196/18636 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e18636 ◽  
Author(s):  
Jobbe P L Leenen ◽  
Crista Leerentveld ◽  
Joris D van Dijk ◽  
Henderik L van Westreenen ◽  
Lisette Schoonhoven ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Clinical Outcomes ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Wireless Devices

Background Continuous monitoring of vital signs by using wearable wireless devices may allow for timely detection of clinical deterioration in patients in general wards in comparison to detection by standard intermittent vital signs measurements. A large number of studies on many different wearable devices have been reported in recent years, but a systematic review is not yet available to date. Objective The aim of this study was to provide a systematic review for health care professionals regarding the current evidence about the validation, feasibility, clinical outcomes, and costs of wearable wireless devices for continuous monitoring of vital signs. Methods A systematic and comprehensive search was performed using PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 2009 to September 2019 for studies that evaluated wearable wireless devices for continuous monitoring of vital signs in adults. Outcomes were structured by validation, feasibility, clinical outcomes, and costs. Risk of bias was determined by using the Mixed Methods Appraisal Tool, quality assessment of diagnostic accuracy studies 2nd edition, or quality of health economic studies tool. Results In this review, 27 studies evaluating 13 different wearable wireless devices were included. These studies predominantly evaluated the validation or the feasibility outcomes of these devices. Only a few studies reported the clinical outcomes with these devices and they did not report a significantly better clinical outcome than the standard tools used for measuring vital signs. Cost outcomes were not reported in any study. The quality of the included studies was predominantly rated as low or moderate. Conclusions Wearable wireless continuous monitoring devices are mostly still in the clinical validation and feasibility testing phases. To date, there are no high quality large well-controlled studies of wearable wireless devices available that show a significant clinical benefit or cost-effectiveness. Such studies are needed to help health care professionals and administrators in their decision making regarding implementation of these devices on a large scale in clinical practice or in-home monitoring.

scholarly journals The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 773
Author(s):  
Wei-Ting Wu ◽  
Tsung-Min Lee ◽  
Der-Sheng Han ◽  
Ke-Vin Chang
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Current Evidence ◽  
Degenerative Spine ◽  
Degenerative Spine Disease ◽  
Spine Disease

The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this systematic review and meta-analysis aimed to summarize the prevalence of sarcopenia in patients with LDSD and examine its impact on clinical outcomes. The electronic databases (PubMed and Embase) were systematically searched from inception through December 2020 for clinical studies investigating the association of sarcopenia with clinical outcomes in patients with LDSD. A random-effects model meta-analysis was carried out for data synthesis. This meta-analysis included 14 studies, comprising 1953 participants. The overall prevalence of sarcopenia among patients with LDSD was 24.8% (95% confidence interval [CI], 17.3%–34.3%). The relative risk of sarcopenia was not significantly increased in patients with LDSD compared with controls (risk ratio, 1.605; 95% CI, 0.321–8.022). The patients with sarcopenia did not experience an increase in low back and leg pain. However, lower quality of life (SMD, −0.627; 95% CI, −0.844–−0.410) were identified postoperatively. Sarcopenia did not lead to an elevated rate of complications after lumbar surgeries. Sarcopenia accounts for approximately one-quarter of the population with LDSD. The clinical manifestations are less influenced by sarcopenia, whereas sarcopenia is associated with poorer quality of life after lumbar surgeries. The current evidence is still insufficient to support sarcopenia as a predictor of postoperative complications.

scholarly journals Compendium of the Health and Wellness Coaching Literature

2017 ◽  
Vol 12 (6) ◽  
pp. 436-447 ◽  
Author(s):  
Gary A. Sforzo ◽  
Miranda P. Kaye ◽  
Irina Todorova ◽  
Sebastian Harenberg ◽  
Kyle Costello ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Behavior Change ◽  
Health Care Professionals ◽  
Health And Wellness ◽  
Inclusion Criteria ◽  
Wellness Coaching ◽  
Treatment Of Diabetes ◽  
Definition Of

Health and wellness coaching (HWC) for lifestyle behavior change is emerging as a practice, role, and profession, in diverse health care, employee wellness, and community settings. Health care professionals apply HWC as a behavior change methodology for the prevention and treatment of diabetes, hypertension, hyperlipidemia, heart disease, cancer, and other chronic disorders. The purpose of this systematic review was to provide a comprehensive and organized compendium of HWC literature. To date, extant HWC literature remains scattered with no meaningful summary accessible. Lack of comprehensive summary stems from lack of consensus on HWC definition and standards. We applied a recently proposed, standardized definition of HWC to determine compendium inclusion criteria for peer-reviewed, data-based literature from relevant search engines (ie, PubMed, PsychInfo, and CINAHL). A systematic review process was executed and ultimately yielded 219 articles meeting HWC inclusion criteria. Of these, 150 were data-based and the remainder were expert opinion or review-style articles. A summary of results generally reveals HWC as a promising intervention for chronic diseases though further research is needed in most categories. The resulting HWC compendium organizes and describes the quantity and quality of available literature for the use and benefit of HWC practitioners and researchers.

scholarly journals Continuous Monitoring of Vital Signs in the General Ward Using Wearable Devices: Randomized Controlled Trial

10.2196/15471 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e15471
Author(s):  
Mariska Weenk ◽  
Sebastian J Bredie ◽  
Mats Koeneman ◽  
Gijs Hesselink ◽  
Harry van Goor ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Controlled Trial ◽  
Vital Signs ◽  
Physician Assistants ◽  
Wearable Devices ◽  
General Ward ◽  
Negative Effects ◽  
Randomized Controlled

Background Wearable devices can be used for continuous patient monitoring in the general ward, increasing patient safety. Little is known about the experiences and expectations of patients and health care professionals regarding continuous monitoring with these devices. Objective This study aimed to identify positive and negative effects as well as barriers and facilitators for the use of two wearable devices: ViSi Mobile (VM) and HealthPatch (HP). Methods In this randomized controlled trial, 90 patients admitted to the internal medicine and surgical wards of a university hospital in the Netherlands were randomly assigned to continuous vital sign monitoring using VM or HP and a control group. Users’ experiences and expectations were addressed using semistructured interviews. Nurses, physician assistants, and medical doctors were also interviewed. Interviews were analyzed using thematic content analysis. Psychological distress was assessed using the State Trait Anxiety Inventory and the Pain Catastrophizing Scale. The System Usability Scale was used to assess the usability of both devices. Results A total of 60 patients, 20 nurses, 3 physician assistants, and 6 medical doctors were interviewed. We identified 47 positive and 30 negative effects and 19 facilitators and 36 barriers for the use of VM and HP. Frequently mentioned topics included earlier identification of clinical deterioration, increased feelings of safety, and VM lines and electrodes. No differences related to psychological distress and usability were found between randomization groups or devices. Conclusions Both devices were well received by most patients and health care professionals, and the majority of them encouraged the idea of monitoring vital signs continuously in the general ward. This comprehensive overview of barriers and facilitators of using wireless devices may serve as a guide for future researchers, developers, and health care institutions that consider implementing continuous monitoring in the ward. Trial Registration Clinicaltrials.gov NCT02933307; http://clinicaltrials.gov/ct2/show/NCT02933307.

scholarly journals Evaluation of Technology-Enhanced Learning Programs for Health Care Professionals: Systematic Review (Preprint)

2017 ◽  
Author(s):  
Pam Nicoll ◽  
Sandra MacRury ◽  
Hugo C van Woerden ◽  
Keith Smyth
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Professionals ◽  
Current Evidence ◽  
Learner Satisfaction ◽  
Average Score ◽  
Technology Enhanced Learning ◽  
Current Evidence Base ◽  
Enhanced Learning ◽  
Satisfaction Surveys

BACKGROUND Technology-enhanced learning (TEL) programs are increasingly seen as the way in which education for health care professionals can be transformed, giving access to effective ongoing learning and training even where time or geographical barriers exist. Given the increasing emphasis on this mode of educational support for health care practitioners, it is vital that we can effectively evaluate and measure impact to ensure that TEL programs are effective and fit for purpose. This paper examines the current evidence base for the first time, in relation to the evaluation of TEL programs for health care professionals. OBJECTIVE We conducted a systematic review of the current literature relating to the evaluation of TEL programs for health care professionals and critically appraised the quality of the studies. METHODS This review employed specific search criteria to identify research studies that included evaluation of TEL for health care professionals. The databases searched included Medline Ovid, Cumulative Index of Nursing and Allied Health Literature Plus Advanced, Applied Social Sciences Index and Abstracts, ZETOC, Institute of Electrical and Electronics Engineers Explore Digital Library, Allied and Complementary Medicine, and Education Resources Information Center between January 2006 and January 2017. An additional hand search for relevant articles from reference lists was undertaken. Each of the studies identified was critically appraised for quality using the Crowe Critical Appraisal Tool. This approach produced a percentage total score for each study across specified categories. A proportion of the studies were independently assessed by an additional two reviewers. RESULTS The review identified 21 studies that met the inclusion criteria. The studies included scored totals across eight categories within a range of 37%-95% and an average score of 68%. Studies that measured TEL using learner satisfaction surveys, or combined pretest and posttest knowledge score testing with learner satisfaction surveys, were found to be the most common types of TEL evaluations evident in the literature. The studies reviewed had low scores across reporting on ethical matters, design, and data collection categories. CONCLUSIONS There continues to be a need to develop effective and standard TEL evaluation tools, and good quality studies that describe effective evaluation of TEL education for health care professionals. Studies often fail to provide sufficient detail to support transferability or direct future TEL health care education programs.

Links Between Perceptions and Practices in Patient Education: A Systematic Review

2019 ◽  
Vol 46 (6) ◽  
pp. 1001-1011 ◽  
Author(s):  
Sandrine Roussel ◽  
Mariane Frenay
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Education ◽  
Health Care Professionals ◽  
Quality Criteria ◽  
World Health ◽  
Health Organization ◽  
The Individual ◽  
Meta Analyses

Background. Two decades after “patient education” was defined by the World Health Organization, its integration in health care practices remains a challenge. Perceptions might shed light on these implementation difficulties. This systematic review aims to investigate links between perceptions and patient education practices among health care professionals, paying particular attention to the quality of practices in order to highlight any associated perception. Method. PubMed, PsycINFO, and Scopus were searched using the following search terms: “perceptions,” “patient education,” “health care professionals,” and “professional practices.” PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used. Results. Twenty studies were included. Overall findings supported the existence of links between some perceptions and practices. Links were either correlational or “causal” (generally in a single direction: perceptions affecting practices). Four types of perceptions (perceptions of the task including patient education, perceptions about the patient, perceptions of oneself as a health care professional, and perceptions of the context) were identified as being linked with educational practices. Links can although be mediated by other factors. Results concerning links should, however, be considered with caution as practices were mostly assessed by prevalence measurements, were self-reported and concerned exclusively individual education. When analyzing the quality of practices, the two retained studies highlighted their changing nature and the central role of perceptions with respect to the individual patient. Conclusions. This literature review led us to specify the quality criteria for further research: covering the entire spectrum of patient education, operationalizing variables, exploring specific practices, measuring the quality of practices, developing designs that facilitate causation findings, and considering a bidirectional perspective.

scholarly journals Continuous Monitoring of Vital Signs in the General Ward Using Wearable Devices: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Mariska Weenk ◽  
Sebastian J Bredie ◽  
Mats Koeneman ◽  
Gijs Hesselink ◽  
Harry van Goor ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Controlled Trial ◽  
Vital Signs ◽  
Physician Assistants ◽  
Wearable Devices ◽  
General Ward ◽  
Negative Effects ◽  
Randomized Controlled

BACKGROUND Wearable devices can be used for continuous patient monitoring in the general ward, increasing patient safety. Little is known about the experiences and expectations of patients and health care professionals regarding continuous monitoring with these devices. OBJECTIVE This study aimed to identify positive and negative effects as well as barriers and facilitators for the use of two wearable devices: ViSi Mobile (VM) and HealthPatch (HP). METHODS In this randomized controlled trial, 90 patients admitted to the internal medicine and surgical wards of a university hospital in the Netherlands were randomly assigned to continuous vital sign monitoring using VM or HP and a control group. Users’ experiences and expectations were addressed using semistructured interviews. Nurses, physician assistants, and medical doctors were also interviewed. Interviews were analyzed using thematic content analysis. Psychological distress was assessed using the State Trait Anxiety Inventory and the Pain Catastrophizing Scale. The System Usability Scale was used to assess the usability of both devices. RESULTS A total of 60 patients, 20 nurses, 3 physician assistants, and 6 medical doctors were interviewed. We identified 47 positive and 30 negative effects and 19 facilitators and 36 barriers for the use of VM and HP. Frequently mentioned topics included earlier identification of clinical deterioration, increased feelings of safety, and VM lines and electrodes. No differences related to psychological distress and usability were found between randomization groups or devices. CONCLUSIONS Both devices were well received by most patients and health care professionals, and the majority of them encouraged the idea of monitoring vital signs continuously in the general ward. This comprehensive overview of barriers and facilitators of using wireless devices may serve as a guide for future researchers, developers, and health care institutions that consider implementing continuous monitoring in the ward. CLINICALTRIAL Clinicaltrials.gov NCT02933307; http://clinicaltrials.gov/ct2/show/NCT02933307.

scholarly journals Teaching through telemedicine: A systematic review of education-focused asthma interventions (Preprint)

2019 ◽  
Author(s):  
Nathan Culmer ◽  
Todd Smith ◽  
Catanya Stager ◽  
Andrea Wright ◽  
Karen Burgess ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Health Care ◽  
Clinical Outcomes ◽  
Video Streaming ◽  
Symptom Burden ◽  
Self Management ◽  
School Based ◽  
Methodological Rigor

BACKGROUND Asthma affects nearly six million children in the United States, with annual school absences totaling 13.8 million days and additional health expenses of $800/year. With limited access to health care in remote locations and underserved communities, telemedicine in a school-based setting involving partnerships between an asthmatic child and health care provider can provide patients with the opportunity to better manage chronic conditions, communicate among partners, and collaborate for solutions. OBJECTIVE The aim of this systematic review is to examine the findings from partnerships involving school-based telemedicine studies using live video streaming to support clinical and educational outcomes for patient-centered care. METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched the peer-reviewed literature with terms related to asthma, education and pediatrics and found 408 unduplicated, relevant articles. A determination to include or exclude each abstract was independently made through reviews by at least two researchers. All conflicts were resolved through a consensus by the two lead authors, resulting in five articles. We then methodically extracted data from these five articles related to a) participant background, b) research methods and purpose, and (c) outcomes (educational, self-management, clinical, quality of life (QOL), and satisfaction). We also used the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool to better understand the methodological rigor of each study. RESULTS Our results support telemedicine in a school-based setting as an effective means of empowering asthmatic children and their families to better manage their asthma and thereby improve quality of life. All projects utilized telemedicine technology and live two-way video streaming. We found a variety of educational and curricular tools used to deliver the sessions, with each study reporting generally positive results in terms of clinical outcomes (such as symptom-free days [SFDs] and health care utilization), learning, self-management of asthma, satisfaction with the intervention, and certain aspects of QOL, but not in terms of self-efficacy. Regarding the methodological rigor of the five studies, we rated two articles as strong, two as moderate, and one as weak. CONCLUSIONS After a review of these five studies, we believe that real-time telemedically delivered asthma education has great potential to improve QOL, enhance symptom management ability, and reduce symptom burden on asthma patients, though the results were mixed across the studies. In terms of clinical outcomes, most, but not all, studies found statistically significant improvements in terms of SFDs, symptom control, peak flow rates, and visits to physicians or an ED. Additionally, we found promising results that patient education can, under proper circumstances, positively influence symptom burden. However, further validation of the methods and tools used for these interventions is both merited and prudent.

scholarly journals Non Pharmacological Interventions to Manage Cancer-Related Fatigue (CRF) - An Overview

2021 ◽  
pp. 42-51
Author(s):  
. Shambhavi ◽  
Diana Lobo
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Cancer Patients ◽  
Health Care Professionals ◽  
Early Period ◽  
Current Evidence ◽  
Evidence Based ◽  
Cancer Related Fatigue ◽  
The Impact

Fatigue is almost a common problem often reported by the cancer patients that severely affects all aspects of quality of life. Prevalence of cancer related fatigue ranges from 50% to 90% of cancer patients overall. After addressing treatable contributing factors, such as hypothyroidism, anemia, insomnia, pain, emotional distress, medication adverse effects, metabolic disturbances, or organ dysfunction such as heart failure, myopathy, and pulmonary fibrosis, patients may be screened with a short fatigue assessment tool. There is a pressure for pharmacologic therapy to shift away from reliance on opioids and ineffective procedures toward comprehensive cancer related fatigue (CRF) management that includes evidence-based nonpharmacologic options. This review details the magnitude of the current CRF problem including its impact on quality of life as well as the challenges of CRF management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Transforming the current system of CRF care to a responsive comprehensive model necessitates those options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. Patients with cancer related fatigue may benefit from self-administrable nonpharmacological interventions without any side effects. Health care personnel often have insufficient knowledge about fatigue and its treatments or underestimate the impact of fatigue on quality of life. A practical review may be useful to health care professionals in order to identify the cancer related fatigue during the early period of cancer process and treat it effectively to improve the quality of life which contribute to the positive outcomes in cancer clients. Therefore, the main purpose of this review is to analyze the possible nonpharmacological approach to manage cancer related fatigue and recommend future research that will clarify these approaches and facilitate the formulation of new treatment options.

scholarly journals Telemedicine Infectious Diseases Consultations and Clinical Outcomes: A Systematic Review

2019 ◽  
Vol 6 (12) ◽  
Author(s):  
Jason P Burnham ◽  
Stephanie A Fritz ◽  
Lauren H Yaeger ◽  
Graham A Colditz
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Cost Effectiveness ◽  
Infectious Diseases ◽  
Clinical Outcomes ◽  
Clinical Effectiveness ◽  
Current Evidence ◽  
Antimicrobial Use ◽  
Cochrane Central Register ◽  
Infectious Diseases Consultation

Abstract Background Telemedicine use is increasing in many specialties, but its impact on clinical outcomes in infectious diseases has not been systematically reviewed. We reviewed the current evidence for clinical effectiveness of telemedicine infectious diseases consultations, including outcomes of mortality, hospital readmission, antimicrobial use, cost, length of stay, adherence, and patient satisfaction. Methods We queried Ovid MEDLINE 1946-, Embase.com 1947-, Scopus 1823-, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov 1997- through August 5, 2019, for studies looking at clinical outcomes of infectious diseases in the setting of telemedicine use. We did not restrict by language or year of publication. Clinical outcomes searched included 30-day all-cause mortality, 30-day readmissions, patient compliance/adherence, patient satisfaction, cost or cost-effectiveness, length of hospital stay, antimicrobial use, and antimicrobial stewardship. Bias was assessed using standard methodologies. PROSPERO CRD42018105225. Results From a search pool of 1154 studies, only 18 involved telemedicine infectious diseases consultation and our selected clinical outcomes. The outcomes tracked were heterogeneous, precluding meta-analysis, and the majority of studies were of poor quality. Overall, clinical outcomes with telemedicine infectious diseases consultation seem comparable to in-person infectious diseases consultation. Conclusions Although in widespread use, the clinical effectiveness of telemedicine infectious diseases consultations has yet to be sufficiently studied. Further studies, or publication of previously collected and available data, are warranted to verify the cost-effectiveness of this widespread practice. Systematic review registration PROSPERO CRD42018105225.

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