Systematic reviews and meta-analyses of home telemonitoring interventions for patients with chronic diseases: a critical assessment of their methodological quality.
Systematic reviews and meta-analyses of home telemonitoring interventions for patients with chronic diseases: a critical assessment of their methodological quality.
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DOI：
10.2196/jmir.2770
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发表时间：
2013-07-23
影响因子：
7.4
通讯作者：
Jaana M
中科院分区：
文献类型：
--
作者：
Kitsiou S;Paré G;Jaana M
在过去的十年中，对慢性病患者家庭远程监护干预措施的系统评价和荟萃分析有所增加，对广泛的临床医生，政策制定者和其他医疗保健利益相关者越来越重要。虽然最近出现了一些关于其方法的严谨性和综合方法的批评，但尚未对其质量进行正式评估。这一关键性审查的主要目的是评价方法，质量和报告的特点，以前的审查，调查家庭远程监护干预措施的影响，在慢性病的背景下。电子检索奥维德MEDLINE、效应综述摘要数据库（DARE）和科克伦图书馆的卫生技术评估数据库（HTA），以查找1966年1月至2012年12月期间发表的相关系统综述。由三名审查员独立筛选和评估潜在的审查。从每个纳入的综述中提取与所用方法相关的数据，并由两名综述者检查其准确性。一个经过验证的质量评估工具，R-AMSTAR，被用来作为一个框架，以指导评估过程。从200多篇引文中识别出24篇综述，其中9篇为荟萃分析。文献检索显示，近年来该领域发表的综述数量大幅增加，尽管大多数综述集中于研究家庭远程监护对充血性心力衰竭患者的影响，但研究人员的兴趣也扩展到其他慢性疾病，如糖尿病、高血压、慢性阻塞性肺病和哮喘。然而，由于内在的方法问题，这些审查中有相当一部分似乎缺乏最佳的科学严谨性。此外，评论的整体质量似乎没有随着时间的推移而改善。虽然所有或几乎所有综述都令人满意地满足了几项标准，例如建立具有纳入和排除标准的先验设计、在多个数据库上使用电子搜索以及报告研究特征，但还有其他重要领域需要改进。重复数据提取、高度相关期刊的手动检索、灰色文献和非英文文献的纳入、纳入研究的方法学质量评估和证据质量评估是不常进行的关键方法学程序。此外，在综合研究结果时发现的某些方法上的局限性影响了一些审查的结果和结论。尽管有方法指南可用于指导系统性审查和荟萃分析的适当进行，并消除潜在的偏倚风险，但这种知识尚未完全纳入家庭远程监护领域。应进一步努力改进这一领域系统性综述和荟萃分析的设计、实施、报告和发表。
Systematic reviews and meta-analyses of home telemonitoring interventions for patients with chronic diseases have increased over the past decade and become increasingly important to a wide range of clinicians, policy makers, and other health care stakeholders. While a few criticisms about their methodological rigor and synthesis approaches have recently appeared, no formal appraisal of their quality has been conducted yet. The primary aim of this critical review was to evaluate the methodology, quality, and reporting characteristics of prior reviews that have investigated the effects of home telemonitoring interventions in the context of chronic diseases. Ovid MEDLINE, the Database of Abstract of Reviews of Effects (DARE), and Health Technology Assessment Database (HTA) of the Cochrane Library were electronically searched to find relevant systematic reviews, published between January 1966 and December 2012. Potential reviews were screened and assessed for inclusion independently by three reviewers. Data pertaining to the methods used were extracted from each included review and examined for accuracy by two reviewers. A validated quality assessment instrument, R-AMSTAR, was used as a framework to guide the assessment process. Twenty-four reviews, nine of which were meta-analyses, were identified from more than 200 citations. The bibliographic search revealed that the number of published reviews has increased substantially over the years in this area and although most reviews focus on studying the effects of home telemonitoring on patients with congestive heart failure, researcher interest has extended to other chronic diseases as well, such as diabetes, hypertension, chronic obstructive pulmonary disease, and asthma. Nevertheless, an important number of these reviews appear to lack optimal scientific rigor due to intrinsic methodological issues. Also, the overall quality of reviews does not appear to have improved over time. While several criteria were met satisfactorily by either all or nearly all reviews, such as the establishment of an a priori design with inclusion and exclusion criteria, use of electronic searches on multiple databases, and reporting of studies characteristics, there were other important areas that needed improvement. Duplicate data extraction, manual searches of highly relevant journals, inclusion of gray and non-English literature, assessment of the methodological quality of included studies and quality of evidence were key methodological procedures that were performed infrequently. Furthermore, certain methodological limitations identified in the synthesis of study results have affected the results and conclusions of some reviews. Despite the availability of methodological guidelines that can be utilized to guide the proper conduct of systematic reviews and meta-analyses and eliminate potential risks of bias, this knowledge has not yet been fully integrated in the area of home telemonitoring. Further efforts should be made to improve the design, conduct, reporting, and publication of systematic reviews and meta-analyses in this area.
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影响因子：
2.1
作者：
Giamouzis G;Mastrogiannis D;Koutrakis K;Karayannis G;Parisis C;Rountas C;Adreanides E;Dafoulas GE;Stafylas PC;Skoularigis J;Giacomelli S;Olivari Z;Triposkiadis F
通讯作者：
Triposkiadis F
影响因子：
9.9
作者：
de Guinea, Ana Ortiz;Webster, Jane;Staples, D. Sandy
通讯作者：
Staples, D. Sandy
影响因子：
6.3
作者：
Downs, SH;Black, N
通讯作者：
Black, N
影响因子：
120.7
作者：
Green, Beverly B.;Cook, Andrea J.;Thompson, Robert S.
通讯作者：
Thompson, Robert S.
DOI：
10.1111/j.1365-2753.2010.01536.x
发表时间：
2011-12-01
影响因子：
2.4
作者：
Bolton, Charlotte E.;Waters, Cerith S.;Elwyn, Glyn
通讯作者：
Elwyn, Glyn