HumanInsight Inconsistent Benefits from Mobile Information Communication Technology in Adults with Peripheral Arterial Disease
Cardiol Rev. 2022 Jun 7. doi: 10.1097/CRD.0000000000000456. Online ahead of print.
quality of evidence regarding telemedicine in adults with peripheral arterial disease (PAD) has not been systematically appraised.
OBJECTIVES: To explore benefits and harms from mobile information communication technology devices and applications in PAD.
METHODS: systematic rapid evidence review and appraisal with the Grading of Recommendations Assessment, Development and Evaluation working group approach.
RESULTS: 16 randomized controlled clinical trials (RCT) examined various self-monitoring devices, telemedicine platforms, and individualized telephone counseling. Low quality evidence suggested that the odds of treatment failure (pooled Peto odds ratio (OR) 0.8 95%I 0.4;1.7; 5 RCTs), adverse effects (pooled Peto OR 0.9 95%CI 0.5;1.5; 2 RCTs) and physical performance (standardized mean difference in 6-minute walking test 0.2 95%CI -0.3; 0.7; 4 RCTs) did not differ between mobile interventions and usual care. Single RCTs suggested large but inconsistent improvement in the quality of life: EuroQol5D standardize mean difference (SMD) = 5.0(95%CI 4.4;5.7)(1 RCT) after telehealth program for promoting patient self-management and SMD = 1.4(95%CI 0.4;2.3) (1 RCT) after structured rehabilitation with mobile self-monitoring. Inconsistent reporting of patient-centered outcomes and small sample sizes hampered the quality of evidence.
CONCLUSIONS: Improved quality of life after specific mobile applications should be confirmed in powered RCTs and large post-marketing studies.
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