Advances in Sensor Monitoring Effectiveness and Applicability: A Systematic Review and Update

Lenouvel, Eric; Novak, Lan; Nef, Tobias; Klöppel, Stefan

doi:10.1093/geront/gnz049

Cited by 10 publications

(9 citation statements)

References 38 publications

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“…Most studies found that technologies were not mature enough to detect activity changes or improve independence [ 88 , 89 , 92 , 105 ]. For monitoring older adults in general, % (3/N) of studies noted weak evidence for detecting changes in ADLs [ 82 - 84 ], and 2 studies showed improved QoL [ 85 , 86 ].…”

Section: Resultsmentioning

confidence: 99%

Evidence and User Considerations of Home Health Monitoring for Older Adults: Scoping Review

Chan¹,

Cohen²,

Robinson³

et al. 2022

JMIR Aging

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Background Home health monitoring shows promise in improving health outcomes; however, navigating the literature remains challenging given the breadth of evidence. There is a need to summarize the effectiveness of monitoring across health domains and identify gaps in the literature. In addition, ethical and user-centered frameworks are important to maximize the acceptability of health monitoring technologies. Objective This review aimed to summarize the clinical evidence on home-based health monitoring through a scoping review and outline ethical and user concerns and discuss the challenges of the current user-oriented conceptual frameworks. Methods A total of 2 literature reviews were conducted. We conducted a scoping review of systematic reviews in Scopus, MEDLINE, Embase, and CINAHL in July 2021. We included reviews examining the effectiveness of home-based health monitoring in older adults. The exclusion criteria included reviews with no clinical outcomes and lack of monitoring interventions (mobile health, telephone, video interventions, virtual reality, and robots). We conducted a quality assessment using the Assessment of Multiple Systematic Reviews (AMSTAR-2). We organized the outcomes by disease and summarized the type of outcomes as positive, inconclusive, or negative. Second, we conducted a literature review including both systematic reviews and original articles to identify ethical concerns and user-centered frameworks for smart home technology. The search was halted after saturation of the basic themes presented. Results The scoping review found 822 systematic reviews, of which 94 (11%) were included and of those, 23 (24%) were of medium or high quality. Of these 23 studies, monitoring for heart failure or chronic obstructive pulmonary disease reduced exacerbations (4/7, 57%) and hospitalizations (5/6, 83%); improved hemoglobin A1c (1/2, 50%); improved safety for older adults at home and detected changing cognitive status (2/3, 66%) reviews; and improved physical activity, motor control in stroke, and pain in arthritis in (3/3, 100%) rehabilitation studies. The second literature review on ethics and user-centered frameworks found 19 papers focused on ethical concerns, with privacy (12/19, 63%), autonomy (12/19, 63%), and control (10/19, 53%) being the most common. An additional 7 user-centered frameworks were studied. Conclusions Home health monitoring can improve health outcomes in heart failure, chronic obstructive pulmonary disease, and diabetes and increase physical activity, although review quality and consistency were limited. Long-term generalized monitoring has the least amount of evidence and requires further study. The concept of trade-offs between technology usefulness and acceptability is critical to consider, as older adults have a hierarchy of concerns. Implementing user-oriented frameworks can allow long-term and larger studies to be conducted to improve the evidence base for monitoring and increase the receptiveness of clinicians, policy makers, and end users.

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Section: Resultsmentioning

confidence: 99%

Evidence and User Considerations of Home Health Monitoring for Older Adults: Scoping Review

Chan¹,

Cohen²,

Robinson³

et al. 2022

JMIR Aging

View full text Add to dashboard Cite

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“…The rapid development of digital health technologies such as software [10], sensors [11], or robots [12,13] requires thorough examination and demonstration of their clinical effectiveness and economic benefits before they are widely deployed in publicly funded health systems. Assessing the value of digital health technologies is complex, with considerations beyond normal health economic analyses [14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Digital Biomarker–Based Interventions: Systematic Review of Systematic Reviews

et al. 2022

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Background The introduction of new medical technologies such as sensors has accelerated the process of collecting patient data for relevant clinical decisions, which has led to the introduction of a new technology known as digital biomarkers. Objective This study aims to assess the methodological quality and quality of evidence from meta-analyses of digital biomarker–based interventions. Methods This study follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline for reporting systematic reviews, including original English publications of systematic reviews reporting meta-analyses of clinical outcomes (efficacy and safety endpoints) of digital biomarker–based interventions compared with alternative interventions without digital biomarkers. Imaging or other technologies that do not measure objective physiological or behavioral data were excluded from this study. A literature search of PubMed and the Cochrane Library was conducted, limited to 2019-2020. The quality of the methodology and evidence synthesis of the meta-analyses were assessed using AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews 2) and GRADE (Grading of Recommendations, Assessment, Development, and Evaluations), respectively. This study was funded by the National Research, Development and Innovation Fund of Hungary. Results A total of 25 studies with 91 reported outcomes were included in the final analysis; 1 (4%), 1 (4%), and 23 (92%) studies had high, low, and critically low methodologic quality, respectively. As many as 6 clinical outcomes (7%) had high-quality evidence and 80 outcomes (88%) had moderate-quality evidence; 5 outcomes (5%) were rated with a low level of certainty, mainly due to risk of bias (85/91, 93%), inconsistency (27/91, 30%), and imprecision (27/91, 30%). There is high-quality evidence of improvements in mortality, transplant risk, cardiac arrhythmia detection, and stroke incidence with cardiac devices, albeit with low reporting quality. High-quality reviews of pedometers reported moderate-quality evidence, including effects on physical activity and BMI. No reports with high-quality evidence and high methodological quality were found. Conclusions Researchers in this field should consider the AMSTAR-2 criteria and GRADE to produce high-quality studies in the future. In addition, patients, clinicians, and policymakers are advised to consider the results of this study before making clinical decisions regarding digital biomarkers to be informed of the degree of certainty of the various interventions investigated in this study. The results of this study should be considered with its limitations, such as the narrow time frame. International Registered Report Identifier (IRRID) RR2-10.2196/28204

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“…This information can be compiled to determine what one's typical activity patterns are and monitor for changes or lapses. SHT can also include video monitoring, which permits even more detailed information to be compiled (see Lenouvel et al, 2019, for a comprehensive review).…”

Section: Novel Technological Assessments Versus Traditional Measures ...mentioning

confidence: 99%

Application of novel technological solutions in the assessment of culturally diverse older adults.

Brothers¹

2023

Practice Innovations

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Advances in Sensor Monitoring Effectiveness and Applicability: A Systematic Review and Update

Cited by 10 publications

References 38 publications

Evidence and User Considerations of Home Health Monitoring for Older Adults: Scoping Review

Evidence and User Considerations of Home Health Monitoring for Older Adults: Scoping Review

Digital Biomarker–Based Interventions: Systematic Review of Systematic Reviews

Application of novel technological solutions in the assessment of culturally diverse older adults.

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