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Wearable health technology and electronic health record integration future directions
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Com os mais recentes avanços tecnológicos, é cada vez mais fácil monitorizar vários parâmetros fisiológicos com sensores portáteis. Este facto proporciona novas oportunidades para a área médica, permitindo a monitorização contínua dos referidos parâmetros.
Nesse sentido, foi concebido o presente estudo, que consiste em uma revisão sistemática da literatura sobre o uso da tecnologia vestível em doenças cardiovasculares, com ênfase no atendimento intra-hospitalar. A pesquisa foi realizada por meio de uma revisão sistemática em bases de dados de referência no período de 26 de dezembro de 2022 a 2 de janeiro de 2023. Foram incluídos na revisão apenas os artigos presentes que atenderam aos critérios de elegibilidade. Os resultados são apresentados da seguinte forma: (1) seleção dos estudos, (2) avaliação do risco de viés, (3) descrição da população estudada e (4) desfechos.
A pesquisa incluiu 14 estudos, todos observacionais. Todos os estudos tinham um elevado risco de viés quando avaliados com a ferramenta RoB 2. Estes artigos incluíram uma população de 5447 doentes com uma idade média de 60 anos. Devido ao elevado risco de viés e à qualidade dos artigos analisados, não foi possível chegar a qualquer conclusão relativamente à eficácia, segurança, adesão e redução da mortalidade com a utilização de cardio-desfibrilhadores portáteis em doentes com elevado risco de morte súbita cardíaca. No entanto, os estudos apontam para a possibilidade desta terapêutica ter uma elevada adesão por parte dos doentes, ser segura e eficaz na terminação das taquidisritmias ventriculares.
Com base nos resultados apresentados, para que se possa recomendar a utilização destas tecnologias vestíveis na prática clínica tem de haver um esforço para fornecer evidência de maior qualidade. Ao mesmo tempo que se desenvolvem as tecnologias vestíveis, é necessário que haja um desenvolvimento correspondente dos registos médicos electrónicos e do processamento de dados, de modo a obter informações úteis para a prática clínica.
With the latest technological advancements, there is an increasing ease of monitoring various physiological parameters with wearable sensors. This provides new opportunities for the medical field, allowing continuous monitoring of said parameters. In line with this, the present study was conceived, consisting in a systematic literature review of the use of wearable technology in cardiovascular diseases, with an emphasis on intrahospital care. The research was conducted through a systematic review in reference databases through the period of 26th of December 2022 to the 2nd of January 2023. Only articles present that met eligibility criteria were included in the review. The results are presented in the following manner: (1) study selection, (2) risk of bias assessment, (3) study population description and (4) outcomes. The research included 14 studies, all observational studies. All the studies had a high risk of bias when evaluated with the RoB 2 tool. These articles comprised a population of 5447 patients with median age of 60 years. Due to the high risk of bias and the quality of the articles reviewed, we weren’t able to come to any conclusion regarding efficacy, safety, compliance and mortality reduction with the use of wearable cardio-defibrillators in patients with high-risk of sudden cardiac death. Although the studies point at the possibility of this therapy having high compliance with the patients, being safe and effective at terminating ventricular tachydysrhythmias. Based on the presented results, to be able to recommend the use of these wearable technologies in clinical practice there has to be an effort to provide higher quality evidence. At the same time that wearables are developed, there needs to be a matching development of electronic medical records and data processing so as to make actionable information for clinical practice.
With the latest technological advancements, there is an increasing ease of monitoring various physiological parameters with wearable sensors. This provides new opportunities for the medical field, allowing continuous monitoring of said parameters. In line with this, the present study was conceived, consisting in a systematic literature review of the use of wearable technology in cardiovascular diseases, with an emphasis on intrahospital care. The research was conducted through a systematic review in reference databases through the period of 26th of December 2022 to the 2nd of January 2023. Only articles present that met eligibility criteria were included in the review. The results are presented in the following manner: (1) study selection, (2) risk of bias assessment, (3) study population description and (4) outcomes. The research included 14 studies, all observational studies. All the studies had a high risk of bias when evaluated with the RoB 2 tool. These articles comprised a population of 5447 patients with median age of 60 years. Due to the high risk of bias and the quality of the articles reviewed, we weren’t able to come to any conclusion regarding efficacy, safety, compliance and mortality reduction with the use of wearable cardio-defibrillators in patients with high-risk of sudden cardiac death. Although the studies point at the possibility of this therapy having high compliance with the patients, being safe and effective at terminating ventricular tachydysrhythmias. Based on the presented results, to be able to recommend the use of these wearable technologies in clinical practice there has to be an effort to provide higher quality evidence. At the same time that wearables are developed, there needs to be a matching development of electronic medical records and data processing so as to make actionable information for clinical practice.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
Wearable Wearable cardio-defibrillator Electronic medical records Cardiologia