The Effect of Smartphone Interventions on Patients With Chronic Obstructive Pulmonary Disease Exacerbations: A Systematic Review and Meta-Analysis.
The Effect of Smartphone Interventions on Patients With Chronic Obstructive Pulmonary Disease Exacerbations: A Systematic Review and Meta-Analysis.
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DOI：
10.2196/mhealth.5921
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发表时间：
2016-09-01
影响因子：
5
通讯作者：
Abu Ashour W
中科院分区：
文献类型：
--
作者：
Alwashmi M;Hawboldt J;Davis E;Marra C;Gamble JM;Abu Ashour W
慢性阻塞性肺疾病（COPD）的患病率和死亡率在全球范围内不断增加。因此，COPD仍然是一个重大的公共卫生问题。人们对使用智能手机技术进行健康促进和疾病管理干预越来越感兴趣。然而，智能手机在减少COPD急性加重患者数量方面的有效性尚不清楚。通过全面的系统性综述和荟萃分析总结和量化智能手机干预与COPD恶化之间的关联。从成立到2015年10月，在相关数据库（PubMed、Embase、科克伦、CINHA、PsycInfo和科克伦图书馆Medline）中进行了全面的检索策略。我们纳入了评估使用智能手机干预与常规护理相比减少COPD急性加重的研究。如果研究者未使用智能手机设备或未报告COPD急性加重，则排除全文研究。观察性研究、摘要和综述也被排除。两名评审员提取数据，并使用美国预防服务工作组质量评级标准进行偏倚风险评估。采用随机效应模型对纳入研究的结果进行荟萃分析。使用合并优势比来衡量智能手机干预对COPD恶化的有效性。使用I2统计量测量杂散性。在筛选的245篇独特引文中，6项研究被纳入定性综合。研究规模相对较小，每项研究的参与者不到100人（范围为30至99人），随访时间为4-9个月。平均年龄为70.5岁（SD 5.6），74%（281/380）为男性。这些研究在国家、智能手机干预类型、参与者数据收集频率和反馈策略方面各不相同。3项研究纳入荟萃分析。纳入荟萃分析的研究的潜在偏倚的总体评估为“良好”（1项研究）和“一般”（2项研究）。在使用智能手机干预的患者中，急性加重患者的合并随机效应比值比为0.20（95% CI 0.07-0.62），与常规治疗相比，智能手机干预降低了80%。然而，在纳入的研究中存在中度异质性（I2=59%）。虽然目前关于智能手机在减少COPD急性加重中的作用的文献有限，但我们的综述结果表明，智能手机在减少COPD急性加重患者数量方面是有用的。然而，使用智能手机需要协同策略来实现预期的结果。由于研究之间的异质性，应谨慎解释这些结果。研究人员应该专注于进行严格的研究，并提供足够的样本量，以确定智能手机干预在COPD管理中的有效性和临床效用。
The prevalence and mortality rates of chronic obstructive pulmonary disease (COPD) are increasing worldwide. Therefore, COPD remains a major public health problem. There is a growing interest in the use of smartphone technology for health promotion and disease management interventions. However, the effectiveness of smartphones in reducing the number of patients having a COPD exacerbation is poorly understood. To summarize and quantify the association between smartphone interventions and COPD exacerbations through a comprehensive systematic review and meta-analysis. A comprehensive search strategy was conducted across relevant databases (PubMed, Embase, Cochrane, CINHA, PsycINFO, and the Cochrane Library Medline) from inception to October 2015. We included studies that assessed the use of smartphone interventions in the reduction of COPD exacerbations compared with usual care. Full-text studies were excluded if the investigators did not use a smartphone device or did not report on COPD exacerbations. Observational studies, abstracts, and reviews were also excluded. Two reviewers extracted the data and conducted a risk of bias assessment using the US Preventive Services Task Force quality rating criteria. A random effects model was used to meta-analyze the results from included studies. Pooled odds ratios were used to measure the effectiveness of smartphone interventions on COPD exacerbations. Heterogeneity was measured using the I2statistic. Of the 245 unique citations screened, 6 studies were included in the qualitative synthesis. Studies were relatively small with less than 100 participants in each study (range 30 to 99) and follow-up ranged from 4-9 months. The mean age was 70.5 years (SD 5.6) and 74% (281/380) were male. The studies varied in terms of country, type of smartphone intervention, frequency of data collection from the participants, and the feedback strategy. Three studies were included in the meta-analysis. The overall assessment of potential bias of the studies that were included in the meta-analysis was “Good” for one study and “Fair” for 2 studies. The pooled random effects odds ratio of patients having an exacerbation was 0.20 in patients using a smartphone intervention (95% CI 0.07-0.62), a reduction of 80% for smartphone interventions compared with usual care. However, there was moderate heterogeneity across the included studies (I2=59%). Although current literature on the role of smartphones in reducing COPD exacerbations is limited, findings from our review suggest that smartphones are useful in reducing the number of patients having a COPD exacerbation. Nevertheless, using smartphones require synergistic strategies to achieve the desired outcome. These results should be interpreted with caution due to the heterogeneity among the studies. Researchers should focus on conducting rigorous studies with adequately powered sample sizes to determine the validity and clinical utility of smartphone interventions in the management of COPD.
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影响因子：
3.7
作者：
Moher D;Shamseer L;Clarke M;Ghersi D;Liberati A;Petticrew M;Shekelle P;Stewart LA;PRISMA-P Group
通讯作者：
PRISMA-P Group
影响因子：
--
作者：
Halpin, David M. G.;Laing-Morton, Tish;Marno, Penny
通讯作者：
Marno, Penny
DOI：
10.1186/1476-069x-12-99
发表时间：
2013-11-21
期刊：
Environmental health : a global access science source
影响因子：
--
作者：
Jehn M;Donaldson G;Kiran B;Liebers U;Mueller K;Scherer D;Endlicher W;Witt C
通讯作者：
Witt C
影响因子：
4.7
作者：
Jarad, Nabil A.;Sund, Zoe M.
通讯作者：
Sund, Zoe M.
DOI：
10.1109/jbhi.2015.2427511
发表时间：
2015-07-01
影响因子：
7.7
作者：
Juen, Joshua;Cheng, Qian;Schatz, Bruce
通讯作者：
Schatz, Bruce